Medication Access Coordinator I

Geisinger•Work from home (Pennsylvania), PA

18h•Remote

About The Position

This role is responsible for obtaining prior authorization for medications, conducting benefit investigations to determine coverage for prescribed treatments, and serving as a liaison with insurance companies, departments, and patients regarding medication prior authorization. The Medication Access Coordinator also acts as a subject matter expert for patient medication assistance foundations and drug replacement programs for uninsured and under-insured populations, while maintaining updated knowledge of pharmacy reimbursement methodologies. The position requires working in an office environment and adhering to all organizational policies and procedures. Relevant experience can be a combination of related work experience and education, where an Associate's Degree counts as 2 years and a Bachelor's Degree counts as 4 years.

Requirements

High School Diploma or Equivalent (GED)
Minimum of 6 years of relevant experience
Communication skills
Computer Literacy
Customer Service skills
Healthcare Industry knowledge
Medical Terminology knowledge

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 and necessary signatures of appropriate paperwork for enrollment in assistance program(s).
Tracks fund award end dates and exhaustion, re-applies as necessary to avoid lapse in therapies.
Communicates with care team to provide details on status of assistance applications.
Educates providers and patients on specialty services and how this improves overall patient care.
Grows the specialty pharmacy’s patient population.
Floats from areas of low workload to areas of heavy workload as needed to provide optional patient services.
Satisfies all job-specific obligations and complies with all organization policies and procedures.