Medication/Copay Assistance Advocate

Mosaic Life Care; Missouri; On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Concierge services

Employee lounge

Wellness programs

Free parking

Job summary

Mosaic Life Care is seeking a Medication/Copay Assistance Advocate to help patients overcome financial barriers to care. The role collaborates with care teams, insurance programs and patient services to secure drug and copay assistance, manage applications, and ensure compliance with regulations.

The position requires pharmacy technician credentials and experience with revenue cycle processes, CPT/J Codes, and pre-certification for medications/infusions.

Qualifications

• High School Diploma required.
• Completion of a nationally recognized Pharmacy Technician Education Program required OR an Associate's Degree in Care Management or related field.
• 1+ years experience with revenue cycle or patient assistance programs required.
• 1+ years knowledge of health insurance pre-certification processes for medications and infusions, and CPT/J Codes associated with those infusions required.
• National or State Certified Pharmacy Technician current or within 1 year required.

Responsibilities

• Identify and evaluate patients for all areas of available assistance (medication, implant, skin substitute donation, copay assistance, and other financial assistance).
• Assist patients and families in applying to program(s) for said assistance as needed.
• Collaborate with healthcare teams to obtain clinical and financial information for enrollment; liaise between patients, physicians, programs and financial services.
• Utilize tools to manage and track patient assistance dollars, drug replacement, copay, and other foundation assistance.
• Coordinate with departments to resolve issues and submit applications timely.
• Knowledge of medication J Codes, CPTs, and billing units.
• Multi-task effectively in a fast-paced environment.

Skills

Microsoft apps

Communication

Time management

Organization

Multi-tasking

Independent work

Professional etiquette

Education

High School Diploma

Pharmacy Technician Education Program

Associate's Degree - Care Management or related field

Job description

Job Description

The Medication/Copay Assistance Advocate will proactively identify and evaluate all areas in supporting patients to reduce economic barriers to care. This individual will have working knowledge of available pharmaceutical drug donation programs, copay assistance and patient assistance support tools, implant and skin substitute donation programs, be knowledgeable of basic revenue cycle processes, and attempt to mitigate all financial toxicity for patients and institution. This caregiver serves as a liaison between network departments, medication manufacturers, copay assistance foundations, health insurance companies, all hospital financial business representatives, as well as all patients, families, and caregivers to facilitate system/resource utilization. Works closely with patient financial services to ensure compliance will all applicable regulations, standards and laws, and department and hospital policies.

Responsibilities

• Identify and evaluate patients for all areas of available assistance. Including, but not limited to; medication, implant, and skin substitute product donation, copay assistance, and all other relevant areas of financial assistance. If needed, assists patients and family/caregivers in applying to program(s) for said assistance.
• Works collaboratively with the healthcare teams to obtain clinical and financial information for assistance program enrollment. a) identifying and assisting with all assistance applications, b) liaising between the patient, the physician offices and clinics, the patient assistance programs(s), and the facility financial services representatives.
• Utilize tools to manage and track all patient assistance dollars, drug replacement, copay assistance, and any other applicable grant or foundation assistance.
• Coordinates with other departments to resolve issues and facilitate timely application submission
• Knowledge of medication J Codes, CPTs, and billing units
• Successful at multi-tasking, and maintains focus and composure in a fast-paced work environment
• Has the ability to calculate (by ratio proportion) the medication dosages with knowledge of the metric measurement conversions

Education

• H.S. Diploma - Required
• Completion of a nationally recognized Pharmacy Technician Education Program - Required OR
• Associate's Degree - Care Management or related field - Required

Work Experience

• 1+ Years - Experience working w/ revenue cycle and/or patient assistance programs - Required
• 1+ Years - Basic knowledge of health insurance pre-certification processes for medications and infusions, and CPT and J Codes associated with those infusions - Required
• Hospital pharmacy experience - Preferred

Licenses and Certifications

• National or State Certified Pharmacy Technician current or within 1 year - Required

Travel Requirements

• Must be able to travel between various system facilities and off-site locations as needed - Required

Qualifications

Skills and Abilities

Essential Technical/Motor Skills

• Basic Microsoft application skills required
• Excellent oral and written communication skills
• Excellent organization and time management skills, and ability to establish priorities effectively
• Dependable in both production and attendance
• Communicates clearly with professional etiquette while using electronic fax, computer, email, Teams, and telephone
• Research and review payer policies, guidelines, and compliance guidelines
• Creative problem-solving skills
• Knowledge of medication J Codes, CPTs, and billing units
• Escalate issues appropriately to leadership
• Ability to work independently and multi-task as needed
• Interacts virtually with team to stay connected and informed

Interpersonal Skills

• Communicate effectively in a professional manor to everyone with whom you may interact no matter the diverse background and able to work both independently and as a team to achieve department and organizational goals while promoting a positive group environment.

Essential Physical Requirements

• Ability to operate equipment on continuous/repetitious basis such as computer, telephone, fax, etc.
• Job requires sitting mostly, walking and standing occasionally.

Essential Mental Abilities

• Ability to analyze and interpret data, explain issues thoroughly, be adaptable in daily responsibilities and flexible based on department and organizational needs, comprehend written and spoken instructions with the ability to retain the information, must be able to organize data and have time management skills and contain the ability to collaborate to resolve any potential billing issues.

Essential Sensory Requirements

• Hearing, speaking, and visual skills.

Exposure to Hazards

• Limited exposure.

About Us

Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.

Mosaic has a wide array of benefits to meet each employee’s individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.