Medication Access Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the medication intake process and act as a liaison between clinic providers, clinic personnel, pharmacies, and patients.

• Perform benefits investigations to assess patient coverage, out-of-pocket expenses, and available financial aid.

• Identify and suggest patient assistance programs, copay cards, grants, or funds.

• Collect and review documentation for prior authorization submissions and escalate appeals for coverage denials.

• Coordinate follow-up actions for insurance denials with clinic personnel.

• Communicate with clinics to gather information and guidance for prior authorization submissions.

• Engage in patient outreach regarding medication coverage and financial assistance options, including pharmacy recommendations.

• Convey coverage decisions and organize patient follow-ups on behalf of client clinics.

• Accurately and promptly document in client EMR systems and Visante tracking tools.

• Support the onboarding and training of client-employed medication access specialists.

• Contribute to the enhancement of processes.

• Collaborate with Visante team members and leadership by providing operational insights and constructive feedback.

• Perform additional duties as assigned.

⛳️ Requirements

• High school diploma or equivalent qualification.

• At least three years of experience in pharmacy within healthcare or with pharmacy providers focused on medication access.

• Two years of experience in healthcare revenue cycle, particularly in medication authorizations and preadmission/precertification processes (preferred).

• Proficient in retail pharmacy PBM adjudication, ensuring precise claim processing and reimbursement.

• Skilled in using CoverMyMeds® for prior authorization submissions.

• State Board of Pharmacy Technician registration to be obtained within two months of the start date, if applicable based on state regulations.

• Active CPhT certification through either PTCB or NHA (preferred).

• Strong judgment and decision-making skills.

• Ability to handle competing priorities, prioritize tasks effectively, and meet deadlines with urgency.

• Excellent interpersonal skills with a focus on team collaboration, along with strong verbal and written communication abilities.

• Expertise in medication reimbursement, prior authorization, and healthcare coding.

• Analytical and innovative problem-solving skills.

• Capability to maintain confidentiality and accuracy.

• Proficiency in Office Suite, including Word, Excel, and PowerPoint.

🏝️ Benefits

• Competitive salary and benefits package.

• Full-time salaried, non-exempt position.

• Fully remote, work-from-home opportunity.