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 bridge between clinic providers, clinic personnel, pharmacies, and patients.

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

• Identify and suggest patient assistance programs, copay cards, grants, or other funding sources.

• Collect and review documentation for prior authorization requests and escalate appeals for coverage denials as needed.

• Coordinate with clinic staff on the next steps regarding insurance denials.

• Liaise with clinics to gather information and guidance for prior authorization requests.

• Conduct outreach to patients regarding medication coverage and financial assistance opportunities.

• Offer recommendations for pharmacy options.

• Communicate coverage decisions and manage patient follow-ups on behalf of client clinics.

• Ensure precise and timely documentation 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 on daily operations.

• Perform additional duties as assigned.

⛳️ Requirements

• High school diploma or equivalent qualification.

• At least three years of pharmacy experience in the healthcare sector or with pharmacy providers focusing on medication access.

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

• Proficiency in retail pharmacy PBM adjudication, ensuring correct claim processing and reimbursement.

• Familiarity with CoverMyMeds® for prior authorization submissions (preferred).

• Registration as a State Board of Pharmacy Technician to be secured 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 capabilities.

• Capacity to handle competing demands, prioritize tasks effectively, and meet deadlines with urgency.

• Exceptional interpersonal, teamwork, verbal, and written communication skills.

• Proficient knowledge in medication reimbursement, prior authorization, and healthcare coding.

• Strong analytical and creative problem-solving skills.

• Ability to uphold confidentiality and accuracy.

• Proficient in Microsoft 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.