Deyan Jason
Prior Authorisation Specialist- Pharmaceutical
Johannesburg ,GP
Summary
Dynamic Prior Authorization Specialist with MSA Outsourcing, skilled in enhancing efficiency and providing effective communication and streamlined processes. Proven ability to reduce turnaround times for authorization decisions while maintaining compliance with insurance procedures and regulations. Expertise in ICD-10 coding and a commitment to exceptional customer service.
Overview
8
8
years of professional experience
Work History
Prior Authorization Specialist
MSA Outsourcing
08.2025 - Current
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Enhanced efficiency in processing prior authorization requests by streamlining documentation procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Coordinated with pharmacy staff to ensure timely dispensing of medications following authorization approval.
- Improved provider satisfaction with timely communications regarding authorization status updates.
- Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Reduced turnaround time for prior authorization decisions by implementing more efficient review process.
- Fostered positive relationships with healthcare providers by ensuring transparent communication throughout authorization process.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Developed comprehensive database of insurance requirements and medication coverage to streamline prior authorization process.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Continually updated knowledge on industry developments, ensuring adherence to best practices and relevant regulatory changes impacting the prior authorization process.
Compliance Coordinator Medical Records
MSA Outsourcing
11.2022 - 07.2025
- Review, audit, and maintain speech and occupational therapy documentation for regulatory compliance
- Ensure adherence to HIPAA, U.S. payer requirements, and client-specific compliance standardsV
- erify completeness and accuracy of clinical notes, evaluations, plans of care, and progress reportsC
- Coordinate with U.S.-based clinicians and administrative teams across time zonesM
- Manage electronic medical records (EMR/EHR) and protect patient health information (PHI)
VAT Reclaim Processing Clerk- Global Currencies
VATit
03.2018 - 03.2022
- Process and submit VAT reclaims in multiple global currencies
- Review invoices and supporting documentation for VAT eligibility and accuracy
- Ensure compliance with country-specific VAT rules and deadlines
- Reconcile VAT amounts and resolve discrepancies
- Maintain accurate records and reporting for audits and reviews
- Liaise with internal finance teams and external tax authorities as required
Education
High School Diploma -
Vorentoe Hoerskool
Johannesburg Skills
Effective communication skills
Data entry
Insurance procedures
ICD-10 coding
Timeline
Prior Authorization Specialist
MSA Outsourcing
08.2025 - Current
Compliance Coordinator Medical Records
MSA Outsourcing
11.2022 - 07.2025
VAT Reclaim Processing Clerk- Global Currencies
VATit
03.2018 - 03.2022
High School Diploma -
Vorentoe Hoerskool