Medication Access Coordinator

Trinity Health

About The Position

The Medication Access Coordinator is responsible for assisting patients through navigating the complexity of medication access at the most affordable expense as possible. They are the liaison between the provider staff, patient, pharmacy, billing, insurance provider, patient communities, social services and other involved parties to drive excellent customer service on behalf of the pharmacy. Problem-solve fulfillment service and insurance concerns and partner with all involved parties to ensure the patient receives the best possible care experience.

Requirements

High School Diploma or GED
Registered or eligible to register as a Pharmacy Technician with the State Board of Pharmacy Examiners within 5 days of hire.
Pharmacy Technician Certification Program.

Nice To Haves

2-year degree in healthcare or related field
Specialty Pharmacy therapies knowledge.
Knowledge of IT applications or ability to efficiently learn (e.g. EMR)
Knowledge of government (Medicaid/Medicare) and third party payer contacts and provider agreements.
Ability to train others.

Responsibilities

Establishes and maintains effective relationships with referral sources, and exemplifies excellent customer service during interactions with patients, employees, providers.
Interface and problem solving, if needed, with the referring provider and/or clinic staff; monitors satisfaction of patients, referring providers and clinical sites regarding referral process and patient care management.
Act as an insurance specialist by expediting the prescription filling process (entering patient demographics, allergies, insurance information); obtain benefit information, verify patient insurance eligibility and level of coverage; understand Medicare/Medicaid regulations and billing guidelines as they pertain to pharmacy patient benefits; understand billing primary, secondary and tertiary insurance claims, and understanding the 340B program and the impact of prescriptions from specialty clinics.
Initiate and assist with the Prior Authorization and Patient Prescription Financial Assistance processes within the assigned therapy classes; resolve billing issues and obtain Prior Authorizations for medications when needed.
Work with Patient Financial Advocates regarding ongoing coverage levels/issues; provide education and training as necessary or instructed.
Interpret and disseminate information, including key information about changes in the marketplace and physician patterns; develop a plan/timetable to monitor program performance with stakeholders on a regular basis.
Maintain patient education materials, collect data, run statistics and monitor productivity.
Create and utilize tools to monitor and report outcomes of initiatives; provide information to Pharmacy managers and Market Director of Pharmacy, as appropriate for review, evaluation and prioritization of opportunities.
Additional retail pharmacy responsibilities as needed: retrieval of prescriptions from patients; data and prescription entry; prescription filling, general phone/customer service involving refills and resolving insurance issues; working the cash register.
Other duties as assigned by the market director of pharmacy.