Medication Access Specialist

COMMUNITY MEMORIAL HOSPITAL - MF • Menomonee Falls, WI • 6h ago

JOB REQUIREMENTS: Location: US:WI:MENOMONEE FALLS at our INTEGRATED SERVICE CENTER facility. This job is HYBRID. \$5,000 sign on bonus! FTE: 1.000000 Standard Hours: 40.00 Shift: 1 Schedule: Monday-Friday, First shift, no weekends or holidays Job Summary: The Medication Access Specialist is a dedicated member of the Pharmacy Department team who is responsible for assuring the financial viability of patients as they flow through the continuum of care. Acts as the liaison between patient, physician office, pharmacy, insurance providers, and other third parties to initiate and resolve appeals, as needed Acts as a liaison between patients, foundations, manufactures or necessary parties, to obtain financial prescription assistance for patients in need Responsible for obtaining 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 record for patients to collect any pertinent information needed to submit, appeal, and resolve prior authorizations and medication refills requests (such as diagnoses, past medical history, past prescription history, and other information) 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 (include telephone, in-basket messaging, and electronic medical record), regarding responses and outcomes of prior authorizations and medication refills Requires appropriate follow up with physician\'s office and any necessary parties in regards to status of prior authorizations and medication refill requests Read, interpret, and effectively communicate information from insurance documents, electronic medical records, patient charts Effectively participate in both written and verbal communication through multiple means (such as electronic health record, in basket messages, phone calls, emails, etc.) Pro blem solve as needed within a timely manner Effective time management of tasks and responsibilities. The ability to discern when it is appropriate to hand off a tasks Detail oriented with ability to effectively and efficiently multi-task Ability to work in a team environment Other duties as assigned EXPERIENCE DESCRIPTION: 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 required. EDUCATION DESCRIPTION: High School diploma or equivalent is required. 4 year degree preferred. Graduate of ASHP accredited pharmacy tech training program preferred. SPECIAL SKILLS DESCRIPTION: Proven attention to detail. Experience with third party insurance and medication/co-pay assistance programs. Effective interpersonal skills, including the ability to develop collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction. Outstanding organizational and follow-up skills. Experience with various computer systems and programs (such as EPIC, insurance portals, McKesson Enterprise, etc.). Quick learner. Ability to work independently and take programmatic initiative. Ability to function in a fast paced and changing environment and bal To view the full job description please use the link below. https://www.aplitrak.com/?adid=YmJnZW5lcmljLjAxNzUwLjg3NzBAZnJvZWR0ZXJ0Y29tcC5hcGxpdHJhay5jb20 *** APPLICATION INSTRUCTIONS: Apply Online: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjAxNzUwLjg3NzBAZnJvZWR0ZXJ0Y29tcC5hcGxpdHJhay5jb20

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