Specialty Pharmacy Access Specialist

Beth Israel Lahey Health; Westwood (MA); On-site; USD 60,000 - 81,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Pharmacy Prior Authorization Liaison to act as a conduit between specialty/retail pharmacy and prescribers, documenting, submitting, communicating outcomes, and appealing when necessary. You will help obtain patient access to prescribed medications and resolve PA issues to ensure timely treatment.

Essential responsibilities include gathering PA data, reviewing documentation, resolving insurance and financial assistance matters, and providing clear

Qualifications

• High School diploma or GED required.
• 3-5 years related work experience required in Pharmacy.
• Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

Responsibilities

• Understands product and payer reimbursement landscape and prior authorization guidelines and processes.
• Collects and reviews all data needed pharmacy and/or medical for prior authorization approvals.
• Resolves insurance related issues, including prior authorizations (PAs), and assist patients with various forms of financial assistance.
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly, maintains frequent phone contact with patient, provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate.
• Serves as the direct patient and provider contact for pharmacy benefit information, clinical and program information.

Skills

Customer service

Written communications

Oral communications

Problem solving

Teamwork

Independence of action

Knowledge of payer processes

Education

High School diploma or GED

Tools

Outlook

Word

Excel

PowerPoint

Access

Job description

Beth Israel Lahey Health is seeking a Pharmacy Prior Authorization Liaison to act as a conduit between specialty/retail pharmacy and prescribers, documenting, submitting, communicating outcomes, and appealing when necessary. You will help obtain patient access to prescribed medications and resolve PA issues to ensure timely treatment.

Essential responsibilities include gathering PA data, reviewing documentation, resolving insurance and financial assistance matters, and providing clear