Pharmacy Patient Access Coordinator

WVU Medicine

2d • Onsite

About The Position

Coordinates, processes and manages manufacturer free drug program participants. Communicates with providers, office staff, & patients to obtain medication orders & financial information, to submit application to manufacturer programs. Communicates with system denials & revenue integrity teams to review claim edits & denials related to pharmaceuticals to ensure proper billing & payment. The successful candidate will ensure timely and accurate completion pharmacy patient access related needs. The candidate should have a strong knowledge of pharmacy and ability to communicate effectively while providing superb customer service.

Position will be focused primarily on prior authorizations for medications with cross training around manufacturer free drug programs.

Requirements

• Bachelor’s degree AND One (1) year of leadership, healthcare, or pharmacy experience; OR Associates degree AND Three (3) year’s pharmacy, leadership, or healthcare experience; OR High school diploma or equivalent AND Five (5) year’s pharmacy, leadership, or healthcare experience.
• Must possess current licensure as required by state board where services will be provided: WV: Pharmacy Technician License or Trainee License through West Virginia Board of Pharmacy
• Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Healthcareer Association (NHA) within 15 months of hire.

Nice To Haves

• Knowledge of drugs, drugs dosing, indications, and proper administration preferred.

Responsibilities

• Manages and monitors the workflow of manufacturer free drug programs to provide efficient patient care.
• Routinely evaluates patient workload and provides recommendations for redistributing in efficient and equitable manner.
• Gathers and documents patient demographics, insurance information, financial status, and other data as needed.
• Initiates follow up communication, schedules deliveries as needed, and works closely with patient care team on treatment plans.
• Conducts and documents staff departmental orientation and training. Manages new employee orientation in all enterprise pharmacy solutions service areas.
• Drafts various correspondence letters, denial appeals, and referrals when necessary.
• Develops and maintains strong working relationships with external, free drug programs, foundations, and vendors.
• Performs medical benefit prior authorizations & benefit investigations for medications provided in clinics or infusion centers at various system facilities as requested.
• Provides suggestions for staffing as needed based on planned and unplanned employee absences.
• Manages & maintains all patient records in a timely and complete manner following department templates and guidelines.
• Meets with DOPs of assigned hospitals on a routine basis to ensure high quality of service is being met.
• Communicates with system denials team to resolve medication related denials, including pulling proof of medical necessity and coordinating written appeals from providers or clinical team.
• Communicates with system revenue integrity team to ensure coding & billing quantities are accurate to our knowledge prior to billing in attempt to limit denials.
• Manages & maintains current state and national registration/certifications.
• Performs in a manner that promotes the work of the pharmacy patient access team and manages expansion of services at assigned sites as needed.
• Extracts clinical notes, labs, and other scanned media in patient’s electronic medical record as necessary to complete assigned tasks.
• Participates in division meetings with manager.
• Consistently ensures that department and hospital policies and procedures are followed and updated as necessary.
• Demonstrates the knowledge and skills necessary to communicate with patients, providers, & payers.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED