Medication Access Specialist
About The Position
How You’ll Impact Patient Care : Your responsibilities may include, but are not limited to: Navigates various options for receiving prior authorization requests and further utilizing systems to find resources that best fit the patient's needs, as applicable. Provides assistance to a subset of patients by completing Patient Assistance Program (PAP) applications and co-pay assistance applications. Assists patients by explaining the medication access process, which may include completing applications and reviewing documents required to complete the application. In collaboration with pharmacists, completes medication reconciliation, reviews prescription claim history for medication adherence and documents findings in the electronic health record, as applicable. Also available to patients and families to triage questions regarding medication access needs. Verifies patient insurance benefits to minimize patient cost. Completes PAP and copay assistance applications, records qualitative monthly/quarterly feedback, refill reminders and medication shipment scheduling, and patient re-enrollment in appropriate assistance programs, as appropriate. Apply co-pay assistance payments to the appropriate patient account, as applicable. Performs data entry and prepares tracking reports for both internal and external stakeholders. Garners and maintains knowledge of Health Plan compliance requirements, healthcare operations, and medical terminology. Efficiently determines a patient's ability to utilize enterprise pharmacy services. Routes prescriptions to appropriate pharmacy, as necessary. Supports the development of methods of communication and coordination with patient care team to ensure timely and accurate fulfillment of orders for patient requests and clients. Maintains updated knowledge and skills and contributes to the education of others. Participates in planning processes by establishing personal goals to support quality improvement efforts and contributes to the achievement of departmental objectives. Audits own performance and recommend objectives and standards of performance. Contributes positively to execution of pharmacy department initiatives. Accepts assignments of tasks from other pharmacy teammate roles when workload dictates. Any other duties as assigned.
Requirements
- High school diploma required or GED equivalent.
- Registration with state board of pharmacy per state of employment requirements.
- Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT).
Nice To Haves
- Associate degree or bachelor’s degree preferred.
- Three years’ pharmacy experience and two years call center or customer service experience highly preferred.
- Retail pharmacy or healthcare/medical group experience and two years of healthcare related billing preferred.
- PTCB technician certification (CPhT) preferred.
- North Carolina Board of Pharmacy registration required within 30 days of employment.
- PTCB technician certification (CPhT) within 180 days of employment.
Responsibilities
- Navigates various options for receiving prior authorization requests and further utilizing systems to find resources that best fit the patient's needs, as applicable.
- Provides assistance to a subset of patients by completing Patient Assistance Program (PAP) applications and co-pay assistance applications.
- Assists patients by explaining the medication access process, which may include completing applications and reviewing documents required to complete the application.
- In collaboration with pharmacists, completes medication reconciliation, reviews prescription claim history for medication adherence and documents findings in the electronic health record, as applicable.
- Also available to patients and families to triage questions regarding medication access needs.
- Verifies patient insurance benefits to minimize patient cost.
- Completes PAP and copay assistance applications, records qualitative monthly/quarterly feedback, refill reminders and medication shipment scheduling, and patient re-enrollment in appropriate assistance programs, as appropriate.
- Apply co-pay assistance payments to the appropriate patient account, as applicable.
- Performs data entry and prepares tracking reports for both internal and external stakeholders.
- Garners and maintains knowledge of Health Plan compliance requirements, healthcare operations, and medical terminology.
- Efficiently determines a patient's ability to utilize enterprise pharmacy services.
- Routes prescriptions to appropriate pharmacy, as necessary.
- Supports the development of methods of communication and coordination with patient care team to ensure timely and accurate fulfillment of orders for patient requests and clients.
- Maintains updated knowledge and skills and contributes to the education of others.
- Participates in planning processes by establishing personal goals to support quality improvement efforts and contributes to the achievement of departmental objectives.
- Audits own performance and recommend objectives and standards of performance.
- Contributes positively to execution of pharmacy department initiatives.
- Accepts assignments of tasks from other pharmacy teammate roles when workload dictates.
- Any other duties as assigned.
Benefits
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
