Position Summary
The Rx Prior Authorization Support Associate (L1) is responsible for efficiently initiating and managing routine prior authorization (PA) requests for medications within the Allegheny Health Network (AHN) system, primarily utilizing Epic. This role focuses on data entry, system navigation, and standardized documentation, while adhering to defined protocols and escalation pathways
L1 associates play a crucial role in ensuring the smooth and timely processing of medication PAs, collaborating closely with U.S.-based teams as needed
Work Location: Chennai
Core Responsibilities
- Monitor and manage the AHN Pharmacy Prior Authorization workqueue in Epic, ensuring adherence to prioritization guidelines
- Initiate Prospective and Retrospective PA requests within Epic, accurately populating all required patient and medication details
- Identify PA statuses and perform routine follow-up actions as per protocol
- Accurately create and update notes/encounters in Epic to document PA-related activities, including chart review, communications, and verdict details
- Upload external faxes or documents into the patient's chart in Epic, saving initial files securely as needed
- Manually enter authorization details (number, start/end dates) into Epic for authorizations received via external means
- Communicate with pharmacies or other entities via fax or secure electronic messaging as per defined processes including direct voice calls
- Identify complex cases, denials, or situations requiring clinical judgment and escalate to the L3 or West team pharmacist according to established protocols
Education
Bachelor’s degree in pharmacy, Medical Technology, Nursing (e.g., B.Pharm, BSc MLT, B.Sc. Nursing from an accredited institution in India, with understanding of medical concepts/pharmacology) or equivalent medical/paramedical education
Experience
1-3 years of experience in a healthcare or pharmaceutical support role, preferably with exposure to medical terminology or claims processing
Skills
- Strong attention to detail and accuracy in data entry and documentation
- Excellent written English communication skills
- Proficiency in computer applications, including Microsoft Office Suite
- Ability to learn and navigate complex healthcare IT systems quickly
- Strong organizational and time management skills to handle multiple tasks efficiently
- Ability to follow strict protocols and escalation pathways
Availability
Must be able to work in shifts that overlap for a few hours with U.S. Eastern Time Zone
About enGen Global
enGen Global is at the forefront of healthcare's Global Capability Centers (GCC) in India, dedicated to creating powerful and innovative solutions that have a transformative impact on lives. The company's cutting-edge solutions empower healthcare partners to manage their operations through comprehensive, proven platforms, enabling them to focus on their core strengths – delivering positive experiences to healthcare consumers and ensuring excellence in service and care. enGen Global’s wide-ranging solutions encompass IT Health Plan and IT Health Consumer Solutions, Application and Platform Management, Enterprise Solutions and Transformations, Development, Testing, Diversified Business Solutions, and Business Process Services. Operating within India's thriving landscape of emerging GCCs, enGen Global boasts a robust partner ecosystem, incorporating best-in-class engineering processes, tools, solution accelerators, talent, research, and co-innovation capabilities.
We believe our people are our greatest asset. The diverse perspectives that our talent bring to our global workforce are foundational to our success. enGen Global is proud to be an equal opportunity employer, committed to fostering a culture of integrity, diversity, and inclusion. We do not discriminate based on any protected characteristic.
