[Hiring] Access Specialist @Navitus Health Solutions, LLC

Role Description

Under the direction of Supervisor, Specialty Pharmacy Services and pharmacists in the Specialty Pharmacy, the Access Specialist is primarily responsible for performing duties to assist patients with access to benefits, copay cards, patient assistance programs or foundations. The Access Specialist will work directly with patients, providers, insurance companies and manufacturers to review all opportunities for financial assistance for specialty medications. The Access Specialist may assist in the scheduling of delivery of prescriptions provided through the specialty pharmacy and assist any other area in the facility as needed with regard to pharmacy technician type duties.

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Responsibilities

• Serve as the liaison between the pharmacy, insurance providers and patient to provide accurate and effective communications regarding financial assistance options and resources.
• Obtain, review and document patient demographics, medication history, and insurance status to identify socioeconomic barriers, opportunities for intervention and eligibility for prescription assistance.
• Improve patient service experience through the provision of benefits investigations and conducting review of all opportunities for coverage of specialty medications.
• Develop a thorough understanding of payer reimbursement and patterns for pharmacy claims with third parties.
• Serve as a primary pharmacy resource to facilitate access to prescription medications, including but not limited to; formulary/coverage issues, copay issues, patient assistance program eligibility, and other programs available.
• Interact with external entities including but not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers and their support staff.
• Review complex insurance situations to educate patients, providers, and clinic staff on how to follow appropriate next steps to get access to prescription and medical benefit information.
• Act in accordance with all applicable federal and state laws and with the highest ethical standards.
• Other duties as assigned.

Qualifications

• Minimum High School Diploma or equivalent; Preferred Associate Degree in Health Science, Business or a related field.
• National CPhT and/or registration/licensure required per employee’s residing state’s requirements.
• One (1) year of experience in a healthcare, business, finance, or insurance related field preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Requirements

• We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Benefits

• Pay Range: USD $1,235.00 - USD $123,456.00 /Yr.