Specialty Pharmacy Coordinator: Prior Authorization & Aid

rivhs; Chesapeake (VA); On-site; USD 33,000 - 43,000; Full time

Job summary

rivhs is seeking a Specialty Medication Coordinator in Chesapeake, VA to manage third-party billing and patient financial assistance for high-dollar specialty medications (e.g., oncology, MS). The role includes benefits investigation, prior authorizations, copay assistance, and patient financial counseling.

Responsibilities include processing referrals, documenting in EMR, ensuring timely follow-ups, and maintaining HIPAA compliance while collaborating across departments to accelerate approvals

Qualifications

• Program Graduate of Pharmacy Technician Training Program, or Licensed Practical Nurse, or Certified Medical Assistant.
• 3-4 years experience as Pharmacy Technician, LPN or CMA (in lieu of education).
• 1 year experience obtaining and managing medication prior authorization.
• 1 year experience obtaining and managing patient assistance programs.
• Familiar with medical and pharmacy terminology.
• Strong communication and customer service skills.

Responsibilities

• Process referrals and submit documentation to insurance carriers to expedite prior authorizations.
• Collaborate with departments to obtain prior authorizations and patient assistance.
• Assist with medical necessity documentation to expedite approvals.
• Follow workflows and policies for prior authorizations.
• Maintain accurate intake documentation in EMR and tracking systems.
• Track patient refills and outreach to ensure timely service.
• HIPAA-compliant handling of patient information.
• Assist with audits, training, and quality compliance.

Skills

Medical terminology

Pharmacy knowledge

Pharmacy calculations

Customer service

Prior authorization

HIPAA compliance

Communication skills

Education

Pharmacy Technician Training Program (Preferred)

Licensed Practical Nurse (Required)

Certified Medical Assistant (Required)

Tools

Pharmacy software

EHR systems

Prior authorization systems

Job description

rivhs is seeking a Specialty Medication Coordinator in Chesapeake, VA to manage third-party billing and patient financial assistance for high-dollar specialty medications (e.g., oncology, MS). The role includes benefits investigation, prior authorizations, copay assistance, and patient financial counseling.

Responsibilities include processing referrals, documenting in EMR, ensuring timely follow-ups, and maintaining HIPAA compliance while collaborating across departments to accelerate approvals