Pharmaceutical Financial Access Specialist
2 weeks ago
Overview
Under the guidance of the Director of Pharmacy and Clinical Coordinator, the Specialty Pharmacy Financial Access Coordinator (I) engages with various hospital personnel, including pharmacists, medical staff, financial teams, department heads, access services representatives, coding professionals, and billing associates. External interactions involve third-party payers, prescription benefit management firms, governmental review organizations, and referring healthcare providers.
Key Responsibilities
1. Manage the receipt of prescriptions and follow up on any claims that have been rejected.
2. Execute prior authorization requests for third-party payers and validate prescriptions.
3. Deliver exceptional customer service by completing applications for the Patient Assistance Program (PAP) and co-pay assistance initiatives.
4. Resolve denied claims effectively.
5. Perform additional tasks as required.
Qualifications
- High School Diploma or GED; Associate's degree or higher is preferred.
- Minimum of 1 year experience as a retail pharmacy technician.
- Preferred 3 years of experience in healthcare billing and/or retail pharmacy.
- Must be registered with the Board of Pharmacy upon hire.
- Certification from the Pharmacy Technician Certification Board (PTCB).
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