Medication Access Specialist

Froedtert • Menomonee Falls, WI

1d • Hybrid

About The Position

The Medication Access Specialist is a dedicated member of the Pharmacy Department team who is responsible for assuring the financial viability of patients as they flow through the continuum of care. Acts as the liaison between patient, physician office, pharmacy, insurance providers, and other third parties to initiate and resolve appeals, as needed Acts as a liaison between patients, foundations, manufactures or necessary parties, to obtain financial prescription assistance for patients in need Responsible for obtaining medication insurance coverage or assistance and benefit information, authorizations of medications, monitors patient's insurance status, assists in facilitating medication refill requests, and communicates insurance issues to the treatment team. Reviews electronic medical record for patients to collect any pertinent information needed to submit, appeal, and resolve prior authorizations and medication refills requests (such as diagnoses, past medical history, past prescription history, and other information) Assists in obtaining updated prescription authorization for existing patients Assists the physician's office in obtaining and completing any and all documentation necessary to complete prior authorization and medication refill requests Updates the patient, physician's office, any necessary parties through multiple methods as appropriate (include telephone, in-basket messaging, and electronic medical record), regarding responses and outcomes of prior authorizations and medication refills Requires appropriate follow up with physician's office and any necessary parties in regards to status of prior authorizations and medication refill requests. Aptitude for accomplishing goals with minimal supervision and working independently with efficiency and self-motivation. Ability and understanding of all aspects and services provided through Froedtert's Specialty pharmacy services Demonstration of collaborating and fostering relationships with providers to ensure patients access to therapy. Other duties as assigned

Requirements

• A minimum of 2 years experience as a Medication Access Specialist 1 (or similar experience).
• Cross trained and demonstrated ability to support prior authorization services in a minimum of 3 different disease states, and/or demonstrated ability to support multiple clinics from a medication refill perspective, and/or demonstrated ability to support all areas in regards to foundation and manufacture assistance.
• Cross trained and demonstrated competence in multiple medication access team responsibilities (such as prior authorizations, foundation and manufacture assistance, and medication refill support).
• High School diploma or equivalent is required.
• Application for Wisconsin registration as a Pharmacy Technician is required by hire date and must be obtained within 12 months of hire. Staff hired into this role prior to 3/31/23 must have applied for Wisconsin registration by 3/31/23 and have until 3/31/24 to obtain registration.
• Certification through Pharmacy Technician Certification Board or National Healthcare Association (ExCPT) required within the first 6 months of hire.
• Proven attention to detail.
• Experience with third party insurance and medication/co-pay assistance programs.
• Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction.
• Outstanding organizational and follow-up skills.
• Experience with various computer systems and programs.
• Quick learner.
• Ability to work independently and take programmatic initiative.
• Ability to function in a fast paced and changing environment and balance multiple priorities.
• Experience with navigating an Electronic Health Record.

Nice To Haves

• Graduate of ASHP accredited pharmacy tech training program preferred.

Responsibilities

• assuring the financial viability of patients
• liaison between patient, physician office, pharmacy, insurance providers, and other third parties to initiate and resolve appeals, as needed
• liaison between patients, foundations, manufactures or necessary parties, to obtain financial prescription assistance for patients in need
• obtaining medication insurance coverage or assistance and benefit information, authorizations of medications
• monitors patient's insurance status
• assists in facilitating medication refill requests
• communicates insurance issues to the treatment team
• Reviews electronic medical record for patients to collect any pertinent information needed to submit, appeal, and resolve prior authorizations and medication refills requests
• Assists in obtaining updated prescription authorization for existing patients
• Assists the physician's office in obtaining and completing any and all documentation necessary to complete prior authorization and medication refill requests
• Updates the patient, physician's office, any necessary parties through multiple methods as appropriate (include telephone, in-basket messaging, and electronic medical record), regarding responses and outcomes of prior authorizations and medication refills
• Requires appropriate follow up with physician's office and any necessary parties in regards to status of prior authorizations and medication refill requests
• accomplishing goals with minimal supervision and working independently with efficiency and self-motivation
• collaborating and fostering relationships with providers to ensure patients access to therapy
• Other duties as assigned

Benefits

• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan - 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees