Financial Access Coordinator
4 weeks ago
Description
Under direct supervision of the Director of Pharmacy and Clinical Coordinator, this Specialty Pharmacy Financial Access Coordinator (I) interacts with hospital employees on multiple levels, including pharmacists, medical/clinical staff, fiscal personnel, department managers, access services staff, coding staff and billing assistants. External contacts include third party payers, prescription benefit management companies, governmental peer review organizations, and referring physicians. This individual is primarily responsible for receiving prescriptions, addressing and rectifying rejected claims, conducting and completing necessary third party (insurance) prior authorization requests (when applicable), and verifies prescriptions to other non-institution entities in instances where the prescription is not filled by Mount Sinais Outpatient Pharmacy, including routing to MSHS entities. S/he is primarily responsible for providing assistance to a subset of patients by completing Patient Assistance Program (PAP) applications and co-pay assistance funds applications. Through PAP, pharmaceutical companies provide medications to patients with limited income and resources.
Responsibilities
1. Receives prescriptions, with appropriate follow up on rejected claims.
2. Completes third party prior authorization requests and verifies prescriptions.
3. Provides a high level of customer service by the completion of applications, including those for the Patient Assistance Program (PAP) and co-pay assistance.
4. Addresses and rectifies denied claims.
5. Other duties as assigned.
Qualifications
- HS/GED; Associates degree or higher preferred
- 1 year of retail pharmacy technician experience
- 3 years of health care related billing and/or retail pharmacy experience preferred
- Registration with the Board of Pharmacy upon hire
- PTCB (Pharmacy Technician)
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