What are the responsibilities and job description for the Medication Access Specialist position at Froedtert Health?
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Location: US:WI:MENOMONEE FALLS at our INTEGRATED SERVICE CENTER facility.
This job is HYBRID.
$5,000 sign on bonus!
FTE: 1.000000
Standard Hours: 40.00
Shift: 1
Schedule: Monday-Friday working 8AM-430PM, no weekends or holidays
Job Summary:
The Medication Access Specialist is a dedicated member of the Pharmacy Department team who is responsible for assuring the financial viability of patients as they flow through the continuum of care. Acts as the liaison between patient, physician office, pharmacy, insurance providers, and other third parties to initiate and resolve appeals, as needed Acts as a liaison between patients, foundations, manufactures or necessary parties, to obtain financial prescription assistance for patients in need Responsible for obtaining medication insurance coverage or assistance and benefit information, authorizations of medications, monitors patient's insurance status, assists in facilitating medication refill requests, and communicates insurance issues to the treatment team. Reviews electronic medical record for patients to collect any pertinent information needed to submit, appeal, and resolve prior authorizations and medication refills requests (such as diagnoses, past medical history, past prescription history, and other information) Assists in obtaining updated prescription authorization for existing patients Assists the physician's office in obtaining and completing any and all documentation necessary to complete prior authorization and medication refill requests Updates the patient, physician's office, any necessary parties through multiple methods as appropriate (include telephone, in-basket messaging, and electronic medical record), regarding responses and outcomes of prior authorizations and medication refills Requires appropriate follow up with physician's office and any necessary parties in regards to status of prior authorizations and medication refill requests Read, interpret, and effectively communicate information from insurance documents, electronic medical records, patient charts Effectively participate in both written and verbal communication through multiple means (such as electronic health record, in basket messages, phone calls, emails, etc.) Problem solve as needed within a timely manner Effective time management of tasks and responsibilities. The ability to discern when it is appropriate to hand off a tasks Detail oriented with ability to effectively and efficiently multi-task Ability to work in a team environment Other duties as assigned.
EXPERIENCE DESCRIPTION:
A minimum of 3 years of experience in pharmacy, healthcare, managed care, or other health insurance environment is required. Knowledge of health insurance and pharmacy insurance benefit verification, health insurance terminology, billing, managed care contracting, hospital reimbursement, and hospital admitting and registrations practices required.
EDUCATION DESCRIPTION:
High School diploma or equivalent is required. 4 year degree preferred. Graduate of ASHP accredited pharmacy tech training program preferred.
SPECIAL SKILLS DESCRIPTION:
Proven attention to detail. Experience with third party insurance and medication/co-pay assistance programs. Effective interpersonal skills, including the ability to develop collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction. Outstanding organizational and follow-up skills. Experience with various computer systems and programs (such as EPIC, insurance portals, McKesson Enterprise, etc.). Quick learner. Ability to work independently and take programmatic initiative. Ability to function in a fast paced and changing environment and balance multiple priorities. Experience with navigating an Electronic Health Record.
LICENSURE DESCRIPTION:
Application for Wisconsin registration as a Pharmacy Technician is required by hire date and must be obtained within 12 months of hire. Staff hired into this role prior to 3/31/23 must have applied for Wisconsin registration by 3/31/23 and have until 3/31/24 to obtain registration. Certification through Pharmacy Technician Certification Board or National Healthcare Association (ExCPT) required within the first 6 months of hire.
Perks & Benefits At Froedtert Health
Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.
Location: US:WI:MENOMONEE FALLS at our INTEGRATED SERVICE CENTER facility.
This job is HYBRID.
$5,000 sign on bonus!
FTE: 1.000000
Standard Hours: 40.00
Shift: 1
Schedule: Monday-Friday working 8AM-430PM, no weekends or holidays
Job Summary:
The Medication Access Specialist is a dedicated member of the Pharmacy Department team who is responsible for assuring the financial viability of patients as they flow through the continuum of care. Acts as the liaison between patient, physician office, pharmacy, insurance providers, and other third parties to initiate and resolve appeals, as needed Acts as a liaison between patients, foundations, manufactures or necessary parties, to obtain financial prescription assistance for patients in need Responsible for obtaining medication insurance coverage or assistance and benefit information, authorizations of medications, monitors patient's insurance status, assists in facilitating medication refill requests, and communicates insurance issues to the treatment team. Reviews electronic medical record for patients to collect any pertinent information needed to submit, appeal, and resolve prior authorizations and medication refills requests (such as diagnoses, past medical history, past prescription history, and other information) Assists in obtaining updated prescription authorization for existing patients Assists the physician's office in obtaining and completing any and all documentation necessary to complete prior authorization and medication refill requests Updates the patient, physician's office, any necessary parties through multiple methods as appropriate (include telephone, in-basket messaging, and electronic medical record), regarding responses and outcomes of prior authorizations and medication refills Requires appropriate follow up with physician's office and any necessary parties in regards to status of prior authorizations and medication refill requests Read, interpret, and effectively communicate information from insurance documents, electronic medical records, patient charts Effectively participate in both written and verbal communication through multiple means (such as electronic health record, in basket messages, phone calls, emails, etc.) Problem solve as needed within a timely manner Effective time management of tasks and responsibilities. The ability to discern when it is appropriate to hand off a tasks Detail oriented with ability to effectively and efficiently multi-task Ability to work in a team environment Other duties as assigned.
EXPERIENCE DESCRIPTION:
A minimum of 3 years of experience in pharmacy, healthcare, managed care, or other health insurance environment is required. Knowledge of health insurance and pharmacy insurance benefit verification, health insurance terminology, billing, managed care contracting, hospital reimbursement, and hospital admitting and registrations practices required.
EDUCATION DESCRIPTION:
High School diploma or equivalent is required. 4 year degree preferred. Graduate of ASHP accredited pharmacy tech training program preferred.
SPECIAL SKILLS DESCRIPTION:
Proven attention to detail. Experience with third party insurance and medication/co-pay assistance programs. Effective interpersonal skills, including the ability to develop collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction. Outstanding organizational and follow-up skills. Experience with various computer systems and programs (such as EPIC, insurance portals, McKesson Enterprise, etc.). Quick learner. Ability to work independently and take programmatic initiative. Ability to function in a fast paced and changing environment and balance multiple priorities. Experience with navigating an Electronic Health Record.
LICENSURE DESCRIPTION:
Application for Wisconsin registration as a Pharmacy Technician is required by hire date and must be obtained within 12 months of hire. Staff hired into this role prior to 3/31/23 must have applied for Wisconsin registration by 3/31/23 and have until 3/31/24 to obtain registration. Certification through Pharmacy Technician Certification Board or National Healthcare Association (ExCPT) required within the first 6 months of hire.
Perks & Benefits At Froedtert Health
Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:
- Paid time off
- Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
- Academic Partnership with the Medical College of Wisconsin
- Referral bonuses
- Retirement plan - 403b
- Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
- Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.