Medication Access Specialist Cancer Center

Kindred Healthcare•Lewiston, ID

2d•Onsite

About The Position

The Medication Access Specialist facilitates timely patient access to prescribed medications by coordinating insurance prior authorizations, benefits investigations, financial assistance programs, and specialty pharmacy services. This role serves as a liaison between patients, providers, payers, pharmacies, pharmaceutical manufacturers, and internal departments to minimize barriers to treatment, optimize reimbursement, and support continuity of care. The Medication Access Specialist maintains accurate documentation, ensures regulatory compliance, and provides exceptional customer service throughout the medication access process.

Requirements

Knowledge of insurance benefits, prior authorization, reimbursement, and specialty pharmacy processes.
Knowledge of pharmaceutical manufacturer assistance and financial assistance programs.
Strong customer service, interpersonal, and relationship-building skills.
Excellent verbal and written communication skills.
Ability to manage multiple priorities while meeting deadlines in a fast-paced environment.
Strong analytical, organizational, and problem-solving abilities.
Proficiency with electronic health records, payer portals, Microsoft Office, and other healthcare technology applications.
Ability to maintain confidentiality and exercise sound judgment with sensitive patient information.
Ability to work independently while collaborating effectively with interdisciplinary teams.
Commitment to providing compassionate, patient-centered service.
High School Diploma or Equivalent including education equivalent to completion of secondary school or demonstrated ability to perform the essential functions of the role.

Nice To Haves

Associate’s Degree Healthcare Administration, Business, Pharmacy Technology, Nursing, or a related field
PHAR-C - Certified Pharmacy Tech (CPhT) National pharmacy technician certification from an accredited certifying body (PTCB or NHA) Upon Hire
2+ years experience in medication access, specialty pharmacy, oncology, prior authorization, revenue cycle, pharmacy operations, or healthcare financial counseling
Prior Experience with electronic health records, payer portals, and specialty pharmacy workflows
Prior Experience in oncology or infusion services

Responsibilities

Coordinates insurance prior authorizations, precertifications, and appeals to obtain timely approval for prescribed medications.
Performs insurance benefits investigations and verifies patient eligibility, coverage, and financial responsibility.
Assists patients with enrollment in manufacturer-sponsored patient assistance, copay assistance, foundation grants, and other financial assistance programs.
Coordinates medication fulfillment with specialty pharmacies, infusion providers, payers, and internal clinical teams to ensure timely initiation and continuation of therapy.
Serves as the primary point of contact for patients regarding medication access, insurance requirements, financial assistance, and treatment status.
Collaborates with physicians, advanced practice providers, nurses, pharmacists, revenue cycle, and external organizations to resolve medication access barriers.
Maintains accurate and timely documentation within the electronic health record and other required systems.
Monitors authorization status, renewals, expiring approvals, and payer requirements to prevent interruptions in therapy.
Educates patients regarding medication access processes, financial assistance resources, and required documentation while maintaining patient confidentiality.
Identifies and escalates reimbursement, authorization, or access issues requiring clinical or leadership intervention.
Maintains current knowledge of payer policies, specialty medications, pharmaceutical assistance programs, and regulatory requirements impacting medication access.
Participates in quality improvement initiatives, process optimization, and departmental performance goals.
Ensures compliance with HIPAA, organizational policies, payer requirements, and applicable federal and state regulations.
Assists with reporting, tracking productivity metrics, and maintaining required records related to medication access activities.
Performs other duties as assigned.