Medication Access Specialist - Pharmacy Technician - FT - Days - MSP

Responsible for performing benefit coverage investigations, initiating, processing, resolving prior authorizations (including denials), helping patients obtain financial assistance from pharmacy related services. Coordinates enrollment, utilization, and ongoing eligibility for manufacturer patient assistance programs to ensure access to medications and compliance with program requirements. Responsible preparing monthly pharmaceutical savings reports and responding to patient assistance program audits.

Responsibilities

Performing benefit coverage investigations; initiating, processing, and resolving prior authorizations (including denials); helping patients obtain financial assistance from pharmacy related services; coordinating enrollment, utilization, and ongoing eligibility for manufacturer patient assistance programs; preparing monthly pharmaceutical savings reports; responding to patient assistance program audits; performing pharmacy benefit investigation and applying knowledge of coverage rules by third party payers, including Medicare and Medicaid; identifying therapies that require certification of medical necessity; working with providers and payers to obtain approval; initiating support for appeals to denied authorizations for pharmacy services; processing patient financial documentation for pharmacy financial assistance eligibility; developing reimbursement payment schedules for patients with special needs; tracking status of expiring reimbursements and processing renewals; improving access to pharmaceutical therapy by performing pharmacy benefit investigation, prior authorizations, copay assistance, enrollment in manufacturer free drug programs, including medication replacement and appeals; tracking, trending and reporting financial data related to drug reimbursement and replacement transactions; coordinating receipt, delivery and distribution of free drug, drug replacements and bulk pharmaceuticals; ensuring compliance with financial and regulatory requirements; coordinating and ensuring appropriate credit to patient accounts when applicable; assessing, assisting and enrolling patients that require financial assistance for pharmacy services; contacting pharmaceutical companies to obtain information and enrolling patients into pharmaceutical patient assistance programs; monitoring and coordinating re-enrollment or transition into additional pharmacy service lines; participating in pharmacy reimbursement initiatives that increase patient access to pharmaceutical services and promotes cost savings to the health system

Requirements

High School Diploma or Equivalent; Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB); Registered Pharmacy Technician (RPT LICENSE) - State of Florida (FL); Three (3) years of pharmacy experience; Proficient understanding of the delivery of healthcare across multiple service lines; Requires critical thinking skills, effective communication skills, decisive judgment; Ability to work with minimal supervision; Ability to work in a stressful environment and take appropriate action; Accountability; Analysis and Decision Making - PHAP; Customer Service; Financial Counseling - Patient Services; Patient and Family Centered Care; Problem Solving; Responding to Change; Standards of Behavior; Verify Insurance; Certified pharmacy technician through a nationally accredited organization