Medication Access Specialist

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.