Medication Access Specialist

4 weeks ago


Menomonee Falls, Wisconsin, United States Froedtert Hospital Full time
Job Summary:

The Medication Access Specialist is a dedicated member of the Pharmacy Department team who is responsible for ensuring the financial viability of patients as they navigate the healthcare system. This role requires strong communication and problem-solving skills to act as a liaison between patients, physicians, pharmacies, insurance providers, and other third parties to initiate and resolve appeals, as needed.

Responsibilities:

Acts as a liaison between patients, foundations, manufacturers, or necessary parties to obtain financial prescription assistance for patients in need
Obtains medication insurance coverage or assistance and benefit information, authorizations of medications, monitors patient's insurance status, assists in facilitating medication refill requests, and communicates insurance issues to the treatment team
Reviews electronic medical records for patients to collect any pertinent information needed to submit, appeal, and resolve prior authorizations and medication refills requests
Assists in obtaining updated prescription authorization for existing patients
Assists the physician's office in obtaining and completing any and all documentation necessary to complete prior authorization and medication refill requests
Updates the patient, physician's office, any necessary parties through multiple methods as appropriate regarding responses and outcomes of prior authorizations and medication refills

Requirements:

A minimum of 3 years of experience in pharmacy, healthcare, managed care, or other health insurance environment is required. Knowledge of health insurance and pharmacy insurance benefit verification, health insurance terminology, billing, managed care contracting, hospital reimbursement, and hospital admitting and registrations practices is also required.

Perks & Benefits:

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 available.

About Froedtert Health:

The Froedtert & Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research, and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians, and more than 45 health centers and clinics, draws patients from throughout the Midwest and the nation. We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages, and retains a diverse workforce.

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