Job Description
Summary:
Responsible for providing access to medications for patients by completing Prior Authorization Requests (PAR), Co-pay Assistance Programs, Medication Assistance Programs, benefits investigation, processing refill renewal requests, assisting patients with health insurance enrollment, managing PAR and prescriptions renewal dates.
Work Schedule:
- Full Time, 1.0 FTE (80 hrs/pp)
- Days and hours may vary
- Day shift
- Non-exempt (hourly)
Responsibilities:
- Coordinates with third-party insurance, clinical staff, and patients to effectively process prior authorization requests for medications within the prescribed timelines.
- Compiles clinical documentation for prior authorizations (ex: progress notes, labs, diagnoses codes, previously tried therapies, ASO criteria, doctor visits). Compiles clinical information for pharmacist and nurses to utilize as refill renewal requests are processed via protocol.
- Directly enrolls eligible patients into manufacturer patient assistance and co-pay programs. Provides information to patients on health care insurance coverage opportunities available through the Health Care Exchanges.
- Accurately obtains and records patients' home medication lists, allergies, immunizations and medical diagnoses.
- Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.
