Hybrid Medication Access Navigator

Froedtert ThedaCare; Menomonee Falls (WI); Hybrid; USD 52,000 - 65,000; Full time

Benefits offered by this job

Paid time off

Growth opportunities

Educational partnerships with Medical,

Referral bonuses

Retirement plan - 403b

Medical, Dental, Vision, Life; STD/LTD

Employee Assistance Programs

Job summary

Froedtert ThedaCare is seeking a Medication Access Specialist in Menomonee Falls, WI. Hybrid role with 40-hour weeks to support the Pharmacy Department by securing insurance coverage, managing prior authorizations, and coordinating with patients, providers, and payers.

Qualified candidates will have at least 3 years in pharmacy/healthcare insurance, a High School diploma or equivalent, and Wisconsin tech registration by hire date; a 4-year degree and ExCPT/CPhT certification are preferred.

Qualifications

• Minimum of 3 years of experience in pharmacy, healthcare, managed care, or health insurance environment.
• Knowledge of health insurance terminology, billing, and prior authorization processes.
• High School diploma or equivalent is required; 4 year degree preferred.
• Wisconsin Pharmacy Technician registration required by hire date; certification (CPhT/ExCPT) within 6 months.

Responsibilities

• Act as liaison between patient, physician, pharmacy, insurance providers, and third parties to initiate and resolve appeals.
• Obtain medication insurance coverage or assistance and authorization information; monitor insurance status.
• Submit information for prior authorizations and medication refills, including diagnoses and history.
• Update patient, physician, and other parties via phone, in-basket messages, and EMR about outcomes.
• Read and interpret insurance documents and communicate effectively across channels.
• Problem solve timely and manage multiple tasks in a team environment.

Skills

Attention to detail

Third party insurance

Interpersonal skills

Organizational skills

EHR navigation

Multi-tasking

Teamwork

Education

High School diploma or equivalent

4 year degree

Tools

EPIC

McKesson Enterprise

Insurance portals

Job description

Froedtert ThedaCare is seeking a Medication Access Specialist in Menomonee Falls, WI. Hybrid role with 40-hour weeks to support the Pharmacy Department by securing insurance coverage, managing prior authorizations, and coordinating with patients, providers, and payers.

Qualified candidates will have at least 3 years in pharmacy/healthcare insurance, a High School diploma or equivalent, and Wisconsin tech registration by hire date; a 4-year degree and ExCPT/CPhT certification are preferred.