Pharmacy Access & Benefits Coordinator

Mount Sinai Health System; New York (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Mount Sinai Health System in New York seeks a Clinical and Financial Access Coordinator to facilitate medication access through insurance prior authorizations, benefits investigations, scheduling, and financial assistance programs.

You will collaborate with pharmacists, clinicians, billing staff, and payers to ensure timely reimbursement, accurate patient data, and adherence to HIPAA guidelines.

Experience coordinating care plans and helping patients overcome barriers to adherence is valued.

Responsibilities

• Receive and triage prescriptions, ensuring accurate patient and insurance information.
• Complete third-party payer prior authorization requests, including medical necessity documentation and follow-up with providers and insurers.
• Resolve claim rejections and provide product overrides when necessary.
• Provide patient education and address benefit inquiries as necessary.
• Process and document applications for Patient Assistance Programs (PAPs) and co-pay support.
• Conduct benefit verification and pharmacy benefit checks at provider request.
• Coordinate patient visits with clinical pharmacists and care team.
• Obtain the patient’s medication history.
• Assist with care plan implementation and resolution of medication adherence barriers.
• Refer patients via telephonic encounters to fill medications at Mount Sinai-owned pharmacies.
• Maintain compliance with HIPAA, payer requirements, and Board of Pharmacy regulations.

Job description

Mount Sinai Health System in New York seeks a Clinical and Financial Access Coordinator to facilitate medication access through insurance prior authorizations, benefits investigations, scheduling, and financial assistance programs.

You will collaborate with pharmacists, clinicians, billing staff, and payers to ensure timely reimbursement, accurate patient data, and adherence to HIPAA guidelines.

Experience coordinating care plans and helping patients overcome barriers to adherence is valued.