Pharmacy Access & Reimbursement Specialist

Socket.dev; New York (NY); On-site; USD 66,000 - 99,000; Full time

Job summary

Mount Sinai Health System in New York seeks a Clinical and Financial Access Coordinator to streamline access to medications, manage prior authorizations, benefits investigations, and PAP applications.

You will collaborate with pharmacists, clinicians, and payers to ensure timely reimbursement, accurate documentation, and compliance with HIPAA, payer rules, and Board of Pharmacy regulations. This full-time role also supports open enrollment and process improvements.

Qualifications

• High School Diploma or GED required; associate degree preferred.
• 3 years healthcare billing and/or managed care reimbursement preferred.
• Pharmacy Technician registration with NY Board of Pharmacy preferred upon hire.
• PTCB Certification required.

Responsibilities

• Receive and triage prescriptions with accurate patient/insurance information.
• Complete third-party payer prior authorization requests with documentation.
• Resolve claim rejections and provide product overrides when necessary.
• Provide patient education and address benefit inquiries.
• Process applications for Patient Assistance Programs (PAPs) and co-pay support.
• Coordinate with clinical pharmacists and care team to ensure timely visits and adherence.

Skills

Oral and written communication

Organizational skills

Multitasking

Interpersonal skills

Judgment and protocol following

Patient confidentiality and customer服务

Education

High School Diploma or GED

Associate degree or higher

Job description

Mount Sinai Health System in New York seeks a Clinical and Financial Access Coordinator to streamline access to medications, manage prior authorizations, benefits investigations, and PAP applications.

You will collaborate with pharmacists, clinicians, and payers to ensure timely reimbursement, accurate documentation, and compliance with HIPAA, payer rules, and Board of Pharmacy regulations. This full-time role also supports open enrollment and process improvements.