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Pharmacy Access Specialist
2 months ago
The Medication Access Specialist is a key member of the Pharmacy Department team, responsible for ensuring the financial viability of patients throughout their care continuum. This role serves as a liaison between patients, physicians, pharmacies, insurance providers, and other third parties to initiate and resolve appeals as needed. The Medication Access Specialist is also responsible for obtaining medication insurance coverage or assistance and benefit information, authorizations of medications, monitoring patient insurance status, and facilitating medication refill requests. Additionally, this role involves reviewing electronic medical records to collect pertinent information for prior authorizations and medication refills, assisting in obtaining updated prescription authorizations, and communicating with patients, physicians, and other parties regarding responses and outcomes.
Responsibilities- Acts as a liaison between patients, physicians, pharmacies, insurance providers, and other third parties to initiate and resolve appeals as needed.
- Obtains medication insurance coverage or assistance and benefit information, authorizations of medications, monitors patient insurance status, and facilitates medication refill requests.
- Reviews electronic medical records to collect pertinent information for prior authorizations and medication refills.
- Assists in obtaining updated prescription authorizations.
- Communicates with patients, physicians, and other parties regarding responses and outcomes.
- A minimum of 3 years of experience in pharmacy, healthcare, managed care, or other health insurance environments.
- Knowledge of health insurance and pharmacy insurance benefit verification, health insurance terminology, billing, managed care contracting, hospital reimbursement, and hospital admitting and registration practices.
- High School diploma or equivalent required; 4-year degree preferred.
- Graduate of ASHP accredited pharmacy tech training program preferred.
Froedtert Health offers a variety of perks and benefits to staff, including paid time off, growth opportunities, academic partnerships, referral bonuses, retirement plans, medical, dental, vision, life insurance, short and long-term disability, free workplace clinics, employee assistance programs, adoption assistance, healthy contributions, moving assistance, discounts on gym memberships, travel, and other work-life benefits.
