Medication Access Specialist

Overview

The medication access specialist will be primarily responsible for the following tasks: proactively reviewing and verifying patients’ drug benefit information to ensure reimbursement requirements are met, processing test claims for medications, conducting third party prior authorization requests, educating patients on DCH retail pharmacy services, proactively obtaining payment information for patients using the DCH retail pharmacy, identifying opportunities for improving reimbursement from payers, documentation of activities on all applicable software platforms, and obtaining accurate patient medication histories.

This position is also responsible for managing all duties of the medication patient assistance recovery programs for DCH, and is responsible for managing and coordinating all activities associated with Specialty Orders.

The position will work with the hospital and clinic employees on multiple levels, including medical/clinical staff, pharmacists, pharmacy technicians, nurses, social workers, and case management members.

Responsibilities

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.

• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.

• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Qualifications

Must be registered as a technician in State of Alabama by start date.   Must have national certification by PTCB or ExCPT. Must have a minimum of one year experience in medication reimbursement and health care insurance preauthorization.  Three years’ experience in pharmacy practice is preferred. Experience with patient assistance programs is preferred. Baccalaureate degree is strongly preferred.  Must be able to operate computer, calculator, telephone, and other pharmacy related equipment.  Prior computer experience using Microsoft Office systems required, Strong communication skills required, Excellent interpersonal skills required, Must be able to work under pressure and meet deadlines, Must be detail oriented with strong follow-up skills, Must have strong telephone presence/etiquette, Must have better than average layman's knowledge of various medications and medication classes.

WORKING CONDITIONS

Able to stand, walk, reach, sit, crouch and stoop for extended periods of time.  Must be able to carry objects weighing 35 pounds.  Requires good motor coordination with good manual and finger dexterity.  Must have the ability to communicate with staff and patients of all ages.  Physical presence onsite is essential.  Hearing and vision must be normal or corrected to within normal range.  Able to perform the duties with or without reasonable accommodation.