Medication Access Coordinator I

Geisinger•Work from home (Pennsylvania), PA

1d•Remote

About The Position

This role is accountable for obtaining prior authorization for medications. The coordinator will complete benefit investigations to determine coverage for prescribed treatments and act as a liaison for all medication prior authorization matters to insurance companies, departments, and patients. This position also serves as a subject matter expert for patient medication assistance foundations, free drug, and drug replacement programs for the uninsured, under-insured, and indigent population. The coordinator must maintain updated knowledge of pharmacy reimbursement methodologies. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Requirements

High School Diploma or Equivalent (GED)
Minimum of 2 years-Related work experience
Communication
Computer Literacy
Customer Service
Healthcare Industry
Medical Terminology
Workplace Organization

Nice To Haves

Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).

Responsibilities

Completes prior authorization and documents referrals for all medications reviewed using appropriate third-party payer criteria.
Conducts research and follow-up activities within established timeframes. Maintains knowledge of criteria changes of third-party payor authorization requirements.
Communicates with care team to provide details on authorization status.
Maintains knowledge of all available patient assistance programs and eligibility requirements.
Identifies available appropriate medication assistance programs upon discussing with patient the affordability of the prescribed treatment.
Ensures accurate completion necessary signatures of appropriate paperwork for enrollment in assistance program(s).
Tracks fund award end dates and exhaustion, re-apply as necessary to avoid lapse in therapies.
Communicates with care team to provide details on status of assistance applications.
Educate providers and patients on specialty services and how this improves overall patient care. Grow the specialty pharmacy’s patient population.
Floats from areas of low workload to areas of heavy workload as needed to provide optional patient services.
Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.