Pharmacy Access Representative III - Home Infusion

The Pharmacy Access Representative III (PAR) is responsible for the overall financial management and coordination for home infusion referrals including removal of barriers that prevent patients from receiving their medications. Duties will include insurance coverage determination, patient out of pocket determination, determination of prior authorization requirements. The PAR will communicate with the prescriber's office to acquire necessary information and assembly of documentation necessary to submit claims to the patient's insurance for approval including prior authorization and helping enroll patients in financial assistance programs. The PAR will link communication between the referral source, patient, pharmacy, insurance, and staff to ensure coordinated care.

Responsibilities

The Pharmacy Access Representative III (PAR) is responsible for the overall financial management and coordination for home infusion referrals including removal of barriers that prevent patients from receiving their medications; Coordinates insurance coverage determination, patient out of pocket determination, and determination of prior authorization requirements; Communicates with the prescriber's office to acquire necessary information and assembles documentation necessary to submit claims to the patient's insurance for approval; Helps enroll patients in financial assistance programs; Links communication between the referral source, patient, pharmacy, insurance, and staff to ensure coordinated care; Coordinates medication and supplies coverage with referral sources and pharmacy staff to ensure timely financial approval; Maintains expertise on all insurance coverage related activities for medical benefit and pharmacy benefit plans; Initiates, documents, and tracks all prior authorization on behalf of the areas

Requirements

At least 18 years of age at the time of application; Associate's degree in Medical, Secretarial, or related field or equivalent combination of education and experience; Minimum of four years of relevant experience or equivalent combination of education and experience; Capable of working independently with minimum supervision; Strong communication skills, problem-solving abilities, and a professional presentation; Customer relations skills; Ability to multi-task, manage many details with accuracy, work under pressure, and maintain professional attitude

Nice to have

Complete ASHP accredited training program or equivalent experience as a pharmacy technician; Certification from a nationally accredited pharmacy technician certification program (Currently PTCB) and maintain ongoing education requirements