Medication Access & Benefits Specialist

ThedaCare; Appleton (WI); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Health coaches

Relaxation rooms

Mental health support

Low copays

Job summary

ThedaCare, located in Appleton, Wisconsin, seeks a Medication Access Specialist in the Pharmacy Department to manage medication coverage, authorizations, and appeals for patients. You will liaise with patients, physicians, and insurers to secure timely access to therapies.

Ideal candidates have 3 years in pharmacy or health insurance, strong insurance knowledge, and excellent communication in a fast-paced setting.

Qualifications

• 3 years of experience in pharmacy, healthcare, or health insurance required.
• Knowledge of health insurance terms, billing, and hospital reimbursement.
• ASHP-accredited pharmacy technician training preferred.

Responsibilities

• Submit, appeal, and resolve prior authorizations and med refills.
• Obtain updated prescription authorizations for existing patients.
• Coordinate with physicians, insurers, and patients to resolve coverage issues.
• Communicate outcomes via phone, messaging, or EMR.
• Maintain timely follow-up on prior authorizations and refills.
• Provide high-level customer service and support across teams.

Skills

Attention to detail

Interpersonal skills

EPIC

McKesson Enterprise

Insurance portals

Electronic Health Record

Education

High school diploma or equivalent

4-year degree preferred

ASHP accredited pharmacy tech training program preferred

Tools

EPIC

McKesson Enterprise

Insurance portals

Electronic Health Record

Job description

ThedaCare, located in Appleton, Wisconsin, seeks a Medication Access Specialist in the Pharmacy Department to manage medication coverage, authorizations, and appeals for patients. You will liaise with patients, physicians, and insurers to secure timely access to therapies.

Ideal candidates have 3 years in pharmacy or health insurance, strong insurance knowledge, and excellent communication in a fast-paced setting.