Specialty Meds Access & Authorization Specialist

CLS Health PLLC; Webster (TX); Sur place; USD 60 000 - 90 000; Plein temps

Avantages offerts par ce poste

401(k) matching

Dental Insurance

Disability insurance

Health insurance

Life insurance

Paid time off

Résumé du poste

CLS Health PLLC in Houston, TX is seeking a skilled Medication Access Specialist to own the end-to-end process for specialty and infused medications. You will navigate payers, biosimilars, and manufacturer programs to move orders from submission to first treatment.

You will review orders, perform benefits investigations, determine patient financial responsibility, and coordinate routing with infusion centers and specialty pharmacies, ensuring seamless patient care.

Qualifications

• 3+ years in medication access or specialty pharmacy intake.
• Experience with J-codes and payer policies.
• Familiarity with copay assistance portals and PAP applications.
• Pharmacy technician certification preferred.

Responsabilités

• Receive and review medication orders from referring providers.
• Complete benefits investigation and determine coverage and patient financial responsibility.
• Determine routing for each order based on payer requirements.
• Submit and follow prior authorizations through payer workflows including appeals.
• Enroll patients in copay programs and PAP for free drug.
• Coordinate medication sourcing with pharmacy and distributor and confirm product selection per payer formulary.
• Schedule initial treatments and hand off to clinical staff.
• Track authorization expirations and reauthorizations.

Connaissances

Medication access

Prior authorization

Specialty pharmacy intake

Payer coordination

Copay assistance portals

Biosimilars knowledge

Formation

Pharmacy technician certification

Outils

Copay portals

Manufacturer hub programs

Description du poste

CLS Health PLLC in Houston, TX is seeking a skilled Medication Access Specialist to own the end-to-end process for specialty and infused medications. You will navigate payers, biosimilars, and manufacturer programs to move orders from submission to first treatment.

You will review orders, perform benefits investigations, determine patient financial responsibility, and coordinate routing with infusion centers and specialty pharmacies, ensuring seamless patient care.