Medication Access Specialist – Ophthalmology Appointment Tech Hub

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Assess medication access requests from Epic In Basket, electronic prior-authorization tools, patient inquiries, MyChart, refill/RxChange messages, fax, clinics, staff assistants, email, and real-time messaging.

• Confirm medication details including prescriber, indication, pharmacy, benefit, urgency, and requested actions.

• Identify barriers such as prior authorization, formulary, step-therapy, quantity limits, tier levels, refill issues, claim processing, specialty pharmacy, documentation, and affordability.

• Investigate plan-specific criteria and preferred submission methods.

• Prepare and submit requests, interpret outcomes, address deficiencies, coordinate reconsiderations and appeals, monitor deadlines, and escalate clinical documentation requirements.

• Review diagnoses, notes, medication history, previous trials, contraindications, allergies, treatment responses, and discrepancies.

• Seek prescriber clarification without making independent treatment decisions.

• Communicate status updates and next steps; clarify claim specifics, brand/NDC, quantity, day supply, refill schedule, and specialty routing.

• Confirm whether approval leads to a payable and affordable prescription.

• Screen for manufacturer copay assistance programs, patient support options, direct-to-consumer alternatives, Medicare Extra Help, specialty pathways, and cash options.

• Maintain thorough Epic documentation, process determination letters, update case statuses, ensure communication with responsible parties, and assist in workload/outcome reporting.

⛳️ Requirements

• Completion of training as an Ophthalmic Technician.

• Certification as a Certified Ophthalmic Technician by the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO).

• BLS Certification.

• Familiarity with ophthalmic terminology, eye diseases, ocular emergencies, ophthalmic medications, and treatment protocols.

• Ability to evaluate patient symptoms, recognize urgent ophthalmic conditions, and prioritize care based on established clinical guidelines.

• Strong critical thinking and clinical decision-making abilities.

• Exceptional verbal and written communication skills.

• Capability to work efficiently in a remote, team-oriented environment.

• Proficient in documenting patient encounters, triage assessments, recommendations, and communications within an electronic medical record.

• Ability to handle multiple priorities at once.

• Capacity to work independently, exercise sound judgment, and utilize available resources effectively.

• Understanding of patient privacy, confidentiality, HIPAA, and regulatory standards.

• Strong organizational and time-management skills.

• Ability to provide patient education and reinforce instructions from providers.

• Willingness to engage in continuous process improvement and adapt to changing workflows.

• Ability to endure prolonged periods of sitting.

🏝️ Benefits

• $5000 Commitment Bonus for eligible candidates.

• Day shifts, Monday through Friday, with no weekends or holidays.

• Remote position.