Emory Healthcare/Emory University Medication Access Specialist in Atlanta, Georgia
JOB DESCRIPTION: The Medication Access Specialist is a dedicated member of the Emory Healthcare Pharmacy Department whose primary responsibility will be navigating patients who are prescribed specialty medications through the intricacies of their insurance benefits in order to maximize medication access and minimize financial burden. The individual acts on behalf of the clinic team, as the liaison between patient, pharmacy, insurance providers, and other third parties to improve patient time to treatment on specialty medications, improve patient satisfaction, and increase profitability to Emory Healthcare. The individual is responsible for obtaining medication insurance coverage and benefit information, authorizations of medications, monitoring of patient insurance status, and communication of medication access issues to the treatment team for all specialty medications within their scope of practice. Obtain detailed insurance benefit information including but not limited to; appropriate billing information (medical vs prescription benefits), copays, in-network pharmacies, plan formulary, prior authorization requirements, and other necessary information to successfully adjudicate a specialty medication claim. Interacts with patients, physicians, caregivers, team members (pharmacists, pharmacy, nurse, provider), and other internal/external stakeholders in a courteous and professional manner. Performs other duties as assigned or requested.
MINIMUM QUALIFICATIONS: High school diploma or equivalent. 5 years' experience in retail pharmacy, healthcare, managed care or health insurance environmental required. Knowledge of health insurance and pharmacy insurance benefits verification, health insurance terminology, billing, managed care contracting, hospital reimbursement required. Strong technical writing and presentation skills required. Strong analytical skills with the ability to collect, analyze and disseminate information. Excellent customer service experience required. Must have and maintain national CPhT certification. Active Pharmacy Technician license in the state of Georgia required.
PHYSICAL REQUIREMENTS (Medium): 20-25 lbs, Up to 50% of the work day; 0-20 lbs of workday Lifting 50 lbs max; Carrying of objects up to 35 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
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Division Emory Univ Hosp-Midtown
Campus Location Atlanta, GA, 30308
Campus Location US-GA-Atlanta
Department EHM Specialty Pharmacy
Job Type Regular Full-Time
Job Number 62720
Job Category Pharmacy
Standard Hours 40 Hours
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.
Emory Healthcare/Emory University
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