Medication Access Specialist

Visante Consulting LLC•Saint Paul, MN

7d•Remote

About The Position

The Medication Access Specialist plays a vital role in Visante’s managed services team, providing integrated remote support to patients, pharmacists, and providers. Responsibilities for this position include streamlining patient intake processes, navigating insurance requirements, enhancing medication access, conducting patient outreach, and reducing the financial burden of high cost prescriptions. Acting as a liaison among pharmacies, clinic staff, and insurance providers, the specialist optimizes treatment initiation and improves patient satisfaction by conducting benefits investigations, handling medication authorizations, managing insurance denials, and identifying assistance programs. The specialist communicates medication options and financial resources to patients while monitoring insurance status and reporting access issues to the treatment team. Emphasizing collaboration and efficiency, this position contributes to Visante’s mission of ensuring patients receive the medications they need and improving patient outcomes.

Requirements

High school diploma or equivalent
Minimum of three years of pharmacy experience in healthcare or with pharmacy providers focused on medication access
State Board of Pharmacy Technician registration obtained within 2 months of start date, if applicable based on state requirements

Nice To Haves

Two years of healthcare revenue cycle experience, including medication authorizations and preadmission/precertification processes.
Expertise in retail pharmacy PBM adjudication, ensuring accurate claim processing and reimbursement.
Proficient in utilizing CoverMyMeds® for prior authorization submissions, streamlining medication access.
Active CPhT certification through either PTCB or NHA

Responsibilities

Lead the medication intake process, serving as a liaison among clinic providers, clinic staff, pharmacies, and patients.
Conduct benefits investigations to determine patient coverage, out-of-pocket costs, and available financial assistance.
Identify and recommend patient assistance programs, copay cards, grants, or funds to reduce financial burdens.
Gather and review necessary documentation for prior authorization submissions, escalating appeals for coverage denials.
Coordinate next steps for insurance denials to clinic staff for review and decision-making regarding appeals process.
Communicate directly with clinics to obtain additional information and guidance related to prior authorization submission.
Conduct patient outreach to discuss medication coverage and financial assistance options, providing pharmacy recommendations.
Communicate coverage determinations and coordinate follow up with patients on behalf of the client clinic.
Ensure timely and accurate documentation in client EMR systems and Visante tracking tools for workflow efficiency.
Assist with onboarding and training of client-employed medication access specialists and contribute to process improvements.
Collaborate with Visante team members and leadership to provide insight and constructive feedback into day-to-day operations.
Complete other duties as assigned.