Medication Access Coordinator

About This Role

This role provides essential medication adherence and prescription assistance support to patients, pharmacists, and clinicians, contributing to the growth and maintenance of Pharmacy business operations.

Responsibilities

• Understands and maintains confidentiality with respect to patient/client care by complying with all applicable federal and state laws, HIPAA, HITECH, and MercyOne policies related to protected health information (PHI) and electronic PHI (ePHI)
• Review payer reports and determine appropriate course of action for management
• Participates in performance improvement (PI) activities, including reporting variances, contributing to corrective action development, and supporting audits
• Determine daily task priorities based on business need
• Triage patient needs and assign to appropriate staff
• Communicate with external entities as needed
• Perform all insurance benefit investigation, review claim rejects, overrides
• Work with patients to find financial aid (grants, manufacturing programs, discount cards etc.) to ensure they have access to the medications they need
• Provide direct support to patients to ensure that they are supported through their therapy regimen and achieve their intended outcome
• Serve as a liaison between clinicians, care coordinators, pharmacy, and assistance programs to ensure patient support throughout care

Requirements

• High School diploma or GED
• At least 18 years of age
• At least three years of experience in pharmacy-related tasks, including health benefit investigations, prior authorization support, patient financial assistance, medical terminology, diagnoses, and procedures
• Proficiency in Microsoft Office products
• Completion of Mandatory Reporter training within 3 months of hire

Qualifications

• High School diploma or GED
• At least three years of experience in pharmacy-related tasks, including health benefit investigations, prior authorization support, patient financial assistance, medical terminology, diagnoses, and procedures.

Nice to Have

• CPhT (Certified Pharmacy Technician), MA (Medical Assistant), or LPN (Licensed Practical Nurse) certification
• Knowledge of Electronic Medical Records systems
• Knowledge of health care payers and specialty pharmacy operations

Skills

* Required skills

Certifications