This position is responsible for working with the Specialty Pharmacy Coordinator, Ambulatory Clinical Pharmacists, the Medication Assistance Coordinator, and the Specialty Pharmacy staff to provide support for patients receiving specialty medications prescribed by St. Peter’s Health providers. Major duties include but are not limited to: Insurance Authorization – perform benefits investigation, obtain insurance prior authorization for specialty medications, pursue appeals for insurance denials, communicate with the specialty pharmacy on the status of medication orders, documents information as needed and follows up on problems or issues; Reimbursement Services – guides patients through the complex approval process to procure specialty medications, assist patients with enrollment in assistance programs including third party, manufacturer, and locally funded plans, follows up with funding programs to confirm patient eligibility and gather all required documentation, communicates with patient, pharmacist, and provider on the status of financial assistance applications and funding; Communication – communicates effectively with insurances companies and internal health care providers, screen, identify and resolve clinical or processing issues related to specialty medications, gather patient information and transmit to specialty pharmacy as directed by the pharmacist, documents all patient interactions.
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Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed