Clinical & Financial Access Navigator for Pharmacy

Mount Sinai; United States; On-site; USD 66,000 - 99,000; Full time

Job summary

Mount Sinai Health System is seeking a Pharmacy Clinical and Financial Access Coordinator in New York, supporting access to medications through prior authorizations, benefits verification, scheduling, and PAP/cost assistance. You will work with pharmacists, clinicians, and payers to ensure timely access and proper reimbursement.

The role involves coordinating with care teams, handling payer communications, and ensuring compliance with HIPAA and regulatory requirements.

Qualifications

• High school diploma or GED required.
• Preferred: associate degree or higher.
• At least 1 year of retail or specialty pharmacy technician experience preferred.
• 3 years healthcare billing/reimbursement or related administrative experience preferred.
• Familiarity with payer plans, PBMs, Medicare/Medicaid, and copay assistance resources.
• Pharmacy Technician registration with NY Board of Pharmacy preferred upon hire.
• PTCB Certification required.

Responsibilities

• Receive and triage prescriptions with accurate patient and insurance info.
• Complete third-party payer prior authorization requests with required documentation.
• Resolve claim rejections and provide product overrides when needed.
• Provide patient education and address benefit inquiries.
• Process PAP and copay assistance applications; verify benefits.
• Coordinate patient visits with clinical pharmacists and care team.
• Maintain HIPAA compliance and detailed activity documentation.

Skills

Payer knowledge

Billing knowledge

Customer service

Communication skills

Education

High School Diploma or GED

Associate degree or higher

NY Pharmacy Technician registration

PTCB Certification

Job description

Mount Sinai Health System is seeking a Pharmacy Clinical and Financial Access Coordinator in New York, supporting access to medications through prior authorizations, benefits verification, scheduling, and PAP/cost assistance. You will work with pharmacists, clinicians, and payers to ensure timely access and proper reimbursement.

The role involves coordinating with care teams, handling payer communications, and ensuring compliance with HIPAA and regulatory requirements.