Pharmacy Technician - Medication Access Specialist - FT - Days - MSS
About The Position
At Memorial Healthcare System (MHS), our ever-growing pharmacy career options present unlimited opportunities to individuals passionate about advancing pharmacy practice. As a nationally recognized and respected leader for providing “A-rated” patient care and safety, MHS prides itself on being able to grow and adapt to the rapidly evolving needs of our community and healthcare industry. Summary: Responsible for performing benefit coverage investigations, initiating, processing, resolving prior authorizations (including denials), helping patients obtain financial assistance from pharmacy related services. Coordinates enrollment, utilization, and ongoing eligibility for manufacturer patient assistance programs to ensure access to medications and compliance with program requirements. Responsible preparing monthly pharmaceutical savings reports and responding to patient assistance program audits.
Requirements
- High School Diploma or Equivalent (Required)
- Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB), Registered Pharmacy Technician (RPT LICENSE) - State of Florida (FL)
- Three (3) years of pharmacy experience.
- Proficient understanding of the delivery of healthcare across multiple service lines.
- Certified pharmacy technician through a nationally accredited organization.
Responsibilities
- Coordinates receipt, delivery and distribution of free drug, drug replacements and bulk pharmaceuticals.
- Assesses, assists and enrolls patients that require financial assistance for pharmacy services.
- Contacts pharmaceutical companies to obtain information and enrolls patients into pharmaceutical patient assistance programs.
- Monitors and coordinates re-enrollment or transition into additional pharmacy service lines.
- Ensures compliance with financial and regulatory requirements.
- Coordinates and ensures appropriates credit to patient accounts when applicable.
- Participates in pharmacy reimbursement initiatives that increase patient access to pharmaceutical services and promotes cost savings to the health system.
- Performs pharmacy benefit investigation and applies knowledge and understanding of the coverage rules by third party payers, including Medicare and Medicaid.
- Identifies therapies that require certification of medical necessity.
- Works with providers and payers to obtain approval.
- Initiates support for appeals to denied authorizations for pharmacy services.
- Processes patient financial documentation for pharmacy financial assistance eligibility.
- Develops reimbursement payments schedules for patients with special needs.
- Tracks status of expiring reimbursements and processes renewals for patients as appropriate.
- Improves access to pharmaceutical therapy by performing pharmacy benefit investigation, prior authorizations, copay assistance, enrollment in manufacturer free drug programs, including medication replacement and appeals as appropriate.
- Tracks, trends and reports financial data related to drug reimbursement and replacement transactions.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
