Remote Medication Access Specialist I

Geisinger; Elm (PA); Remote; USD 65,000 - 85,000; Full time

Job summary

Geisinger is seeking a dedicated professional to obtain prior authorizations for medications and to determine coverage through benefit investigations. The role coordinates with insurance companies, departments, and patients, serving as a subject matter expert for patient medication assistance foundations, free drug and replacement programs for uninsured or under-insured populations.

The position requires knowledge of pharmacy reimbursement methodologies and offers a base in a home-based

Qualifications

• High School Diploma or GED required.
• Minimum of 2 years related work experience required.

Responsibilities

• Completes prior authorization and documents referrals for all medications reviewed using appropriate third-party payer criteria.
• Conducts research and follow-up activities within established timeframes. Maintains knowledge of criteria changes of third-party payor authorization requirements.
• Communicates with care team to provide details on authorization status.
• Maintains knowledge of all available patient assistance programs and eligibility requirements.
• Identifies available appropriate medication assistance programs upon discussing with patient the affordability of the prescribed treatment.
• Ensures accurate completion necessary signatures of appropriate paperwork for enrollment in assistance program(s).
• Tracks fund award end dates and exhaustion, re-apply as necessary to avoid lapse in therapies.
• Communicates with care team to provide details on status of assistance applications.
• Educate providers and patients on specialty services and how this improves overall patient care. Grow the specialty pharmacy’s patient population.
• Floats from areas of low workload to areas of heavy workload as needed to provide optional patient services.
• Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.

Education

High School Diploma or Equivalent (GED)

Job description

Geisinger is seeking a dedicated professional to obtain prior authorizations for medications and to determine coverage through benefit investigations. The role coordinates with insurance companies, departments, and patients, serving as a subject matter expert for patient medication assistance foundations, free drug and replacement programs for uninsured or under-insured populations.

The position requires knowledge of pharmacy reimbursement methodologies and offers a base in a home-based