Medication Access Specialist - Pharmacy Technician - FT - Days - MSP

Responsibilities

• 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.
• Captures, delivers and distributes free drugs, drug replacements and bulk pharmaceuticals.
• Ensures compliance with financial and regulatory requirements.
• Congresses and ensures appropriate credits to patient accounts when applicable.
• Affords, 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.
• Participates in pharmacy reimbursement initiatives that increase patient access to pharmaceutical services and promote cost savings to the health system.

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)

Qualifications

• Three (3) years of pharmacy experience.
• Proficient understanding of the delivery of healthcare across multiple service lines.