What are the responsibilities and job description for the Coverage & Access Coordinator position at LeMed Specialty Pharmacy?
Pay from $22 per hour
About Us:
LeMed Specialty Pharmacy is dedicated to supporting patients with rare diseases by providing compassionate, high-touch care that goes beyond medication dispensing. We work closely with patients, caregivers, healthcare providers, and payers to ensure a seamless treatment journey. We are committed to serving the needs of patients, providers and caregivers with fully redundant, bi-coastal locations and nationwide licensure. We’re proud of our 20 year history of shaping the future of healthcare.
Job Summary:
As a Coverage and Access Coordinator, you will be responsible for conducting detailed benefit investigations, processing prescription claims, and resolving coverage challenges to facilitate timely medication access. You will work directly with patients, healthcare providers, insurers, and financial assistance programs to secure approvals, minimize costs, and ensure uninterrupted therapy.
Candidates are required to live in a commutable distance from the pharmacy. This position is required to be available to work onsite Monday - Friday between the hours of 8:30am and 5:00 pm MT.
Key Responsibilities:
- Conduct in-depth benefit investigations to determine patients’ insurance coverage, copay requirements, and out-of-pocket costs.
- Process prescription claims and proactively resolve claim rejections by working with insurers, pharmacy benefit managers (PBMs), and prescribers.
- Prepare and submit prior authorizations (PAs) and formulary exception requests, following up diligently to expedite approvals.
- Identify and facilitate financial assistance options, including manufacturer copay programs, foundation grants, and patient assistance programs (PAPs).
- Communicate effectively with patients, providers, and internal teams to provide updates on claim status, coverage options, and next steps.
- Maintain meticulous documentation of all patient interactions, benefit verification details, and claim resolutions.
- Stay informed on insurance policies, formularies, and reimbursement trends to optimize patient access strategies.
- Collaborate closely with Patient Care Coordinators, pharmacists, and other team members to ensure a seamless patient experience.
Salary : $22
