Specialty Pharmacy Medication Access Coordinator

Responsibilities

• Provide medication access and affordability services by completing the following:
• Conduct prospective benefits investigation services to expedite clinic workflow and enhance patient care
• Review prior authorization requests received from clinic staff
• Review documentation in the patient's medical record that is required for prior authorization submission
• P benefits investigation review upon third party payor determination to assess patients coverage and out of pocket costs
• Identify financial options that could be utilized to reduce patient financial burden including but not limited to copay cards, grants, foundations or manufacturer patient assistance programs.
• Communicate with clinic staff for any clinical information or guidance related to prior authorization submission and determination
• Assist the clinic in submitting appeals and independent reviews related to coverage denials
• Demonstrate proficiency and skill with pharmacy and health system information systems
• Ensure timely and accurate documentation related to services provided to providers, clinic staff and patients/families
• Manage and process incoming and outgoing calls in call center including:
• Processing medication orders
• Refill reminders
• Providing order updates
• Providing prior authorization updates and details
• Collaborating with other staff for patient needs
• Effectively communicate with other pharmacy team members, physicians, nurses and patients/families
• Resolve routine medication-related issues and ensure medication transactions are processed accurately and appropriately
• Complete other duties as assigned by supervisor or pharmacist regarding medication access and other patient care needs

Requirements

• High School diploma or equivalent combination of education (GED)
• Certification: Registration as a “Registered Ohio Pharmacy Technician” or “Pharmacy Technician Trainee” required. National Pharmacy Technician Certification (PTCB or equivalent required).
• Years of relevant experience: 3 to 5 years is preferred
• Years of experience supervising: none