Pharmacy Access & Prior Authorization Specialist

Mount Sinai Medical Center; New York (NY); On-site; USD 66,000 - 99,000; Full time

Job summary

Mount Sinai Health System seeks a Clinical and Financial Access Coordinator to facilitate medication access through prior authorizations, PAPs, and benefit verification. You will coordinate with pharmacists, clinicians, and payers to ensure timely access and accurate reimbursements.

The role requires strong communication, organizational skills, and HIPAA compliance in a fast-paced hospital setting, with opportunities to lead and mentor junior staff as needed.

Qualifications

• Strong communication skills, both written and verbal.
• Excellent organizational skills and attention to detail.
• Ability to multitask in a fast-paced healthcare environment.
• Effective interpersonal skills with internal and external stakeholders.
• Sound judgment and adherence to protocols.
• Commitment to patient confidentiality and service excellence.

Responsibilities

• Receive and triage prescriptions with accurate patient/insurance info.
• Complete prior authorization requests with medical necessity documentation.
• Resolve claim rejections and provide overrides when needed.
• Educate patients and address benefit inquiries.
• Process applications for PAPs and copay support.
• Verify benefits and perform pharmacy benefit checks on request.

Skills

Communication skills

Organizational skills

Multitasking

Customer service

Attention to detail

Education

High School Diploma or GED

Associate degree or higher

Job description

Mount Sinai Health System seeks a Clinical and Financial Access Coordinator to facilitate medication access through prior authorizations, PAPs, and benefit verification. You will coordinate with pharmacists, clinicians, and payers to ensure timely access and accurate reimbursements.

The role requires strong communication, organizational skills, and HIPAA compliance in a fast-paced hospital setting, with opportunities to lead and mentor junior staff as needed.