Medication Access Specialist

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

📋 Description

• Oversee the medication intake process, acting as an intermediary among clinic providers, staff, pharmacies, and patients.

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

• Identify and suggest patient assistance programs, copay cards, grants, or funds aimed at alleviating financial burdens.

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

• Coordinate subsequent actions regarding insurance denials with clinic staff for appeal resolutions.

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

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

• Relay coverage determinations and manage follow-up with patients on behalf of client clinics.

• Maintain accurate 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 everyday operations.

• Fulfill other responsibilities as assigned.

⛳️ Requirements

• High school diploma or equivalent qualification.

• A minimum of three years of pharmacy experience in healthcare or with pharmacy providers focused on medication access.

• Preferably two years of experience in healthcare revenue cycle, including medication authorizations and preadmission/precertification processes.

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

• Familiarity with utilizing CoverMyMeds® for prior authorization submissions is preferred.

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

• Active CPhT certification through either PTCB or NHA is preferred.

• Strong judgment and decision-making capabilities.

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

• Excellent interpersonal, team collaboration, verbal, and written communication skills.

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

• Strong analytical and creative problem-solving skills.

• Ability to uphold confidentiality and maintain accuracy.

• Proficient in the Office Suite (Word, Excel, PowerPoint).

🏝️ Benefits

• Competitive salary and benefits package.

• Full-time salaried, non-exempt position.

• Fully remote, work-from-home opportunity.