Medication Access Coordinator I

Geisinger•Work from home (Pennsylvania), PA

5d•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 treatment and act as a liaison for all medication prior authorization matters to insurance companies, departments, and patients. Additionally, the coordinator will serve as a subject matter expert for patient medication assistance foundations, free drug, and drug replacement programs for the uninsured, under-insured, and indigent population. This position requires maintaining updated knowledge of pharmacy reimbursement methodologies. The work is typically performed in an office environment.

Requirements

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

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 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.
Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.