Pharmacy Patient Access Coordinator

WVU Medicine

About The Position

Coordinates, processes, and manages participants in manufacturer free drug programs. Communicates with providers, office staff, and patients to obtain medication orders and financial information and to submit applications to manufacturer programs. Works with system denials and revenue integrity teams to review pharmaceutical claim edits and denials and support proper billing and payment. Ensures timely and accurate completion of pharmacy patient access needs and provides strong pharmacy knowledge and effective communication with superb customer service. The role also supports patient access workflows, medication benefit investigations and prior authorizations, staff orientation and training, patient-record maintenance, appeals, and service expansion at assigned sites. Other duties may be assigned.

Requirements

Bachelor’s degree and one year of leadership, healthcare, or pharmacy experience; or an associate degree and three years of pharmacy, leadership, or healthcare experience; or a high school diploma or equivalent and five years of pharmacy, leadership, or healthcare experience.
Current licensure as required by the state board where services are provided; in West Virginia, a Pharmacy Technician License or Trainee License through the West Virginia Board of Pharmacy is required.
Obtain national Pharmacy Technician certification through the Pharmacy Technician Certification Board (PTCB) or National Healthcareer Association (NHA) within 15 months of hire.
High level of interpersonal skills and poise.
Excellent verbal, written, and decision-making skills.
Polite and respectful communication with staff, physicians, patients, and families, and a positive approach to interpersonal relations.

Nice To Haves

Knowledge of drugs, drug dosages, indications, and proper administration.

Responsibilities

Manage and monitor manufacturer free drug program workflows to provide efficient patient care.
Evaluate patient workload and recommend efficient and equitable redistribution.
Gather and document patient demographics, insurance information, financial status, and other required data.
Initiate follow-up communications, schedule deliveries as needed, and work with the patient care team on treatment plans.
Conduct and document departmental staff orientation and training, including new employee orientation across enterprise pharmacy solutions service areas.
Draft correspondence, denial appeals, and referrals as needed.
Develop and maintain working relationships with external free drug programs, foundations, and vendors.
Perform medical benefit prior authorizations and benefit investigations for medications provided in clinics or infusion centers at system facilities as requested.
Recommend staffing adjustments based on planned and unplanned employee absences.
Maintain complete and timely patient records according to departmental templates and guidelines.
Meet routinely with DOPs of assigned hospitals to ensure service quality.
Work with the system denials team to resolve medication-related denials, including obtaining proof of medical necessity and coordinating written appeals from providers or the clinical team.
Work with the system revenue integrity team to check coding and billing quantities before billing, with the goal of limiting denials.
Maintain current state and national registrations and certifications.
Promote the pharmacy patient access team’s work and manage service expansion at assigned sites as needed.
Extract clinical notes, laboratory results, and other scanned media from patients’ electronic medical records as needed.
Participate in division meetings with the manager.
Ensure department and hospital policies and procedures are followed and updated as needed.
Communicate effectively with patients, providers, and payers.