Medication Access Specialist

Madison, Wisconsin
Insurance (Management Occupations)
Job Type
Working Hours
8:00 AM - 5:00 PM
US$ 17.00 per hour
Ref. Number
Moto Gladys Igahara, Spherion
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Job Description

The Medication Access Specialist assists patients, clinic staff and insurance staff by coordinating insurance authorization through patients' medical and pharmacy benefits. The Specialist will obtain and complete preauthorization, exceptions to coverage, appeals, and medical necessity documentation and submit to patient's insurance or prescription benefit manager. This role will also assist obtaining financial assistance through other means if the patient's insurance benefit does not cover the requested treatment and the provider and patient wish to pursue the treatment. The Specialist will be responsible for maintaining an organized plan of documentation and communication throughout patient care within the EHR

- Prior Authorizations(PA) and Exception to Coverage(ETC)
- Assist with un-insured, under-insured or low-income patients with obtaining required information, completing necessary requirements, and understanding the claim process to access medication,
- Serve as a liaison for patients regarding any billing concerns
- Assist patients with claim appeals
- Insurance Investigation and Coverage ??? pre-treatment investigation of specific insurance details
- Coordinate with other specialists to ensure compliance with accreditation and legal requirements
- Other duties as assigned

Working hours: 8:00 AM - 5:00 PM

- Knowledge of medical and pharmacy terminology and benefits.
- Self-motivated with the ability to work independently in a variety of assignment areas.
- Strong customer service and communication skills over the phone, computer or in person.
- Good computer skills for entering and retrieving information from the pharmacy computer system.
- Service oriented with the ability to work in a fast paced, ever changing environment and the ability to resolve customer concerns.


1-4 years

- Bachelor???s degree in relevant field with insurance, pharmacy, medication knowledge or Highschool with at least 1 year of relevant training and 3 years??? experience in a healthcare environment possessing insurance, pharmacy, and/or medication knowledge
- Pharmacy Technician Certification (CPhT) or completion of certification within 1 year of taking the position.

- Experience with EPIC software, Microsoft Applications, Cover My Meds, and proper internet application procedures.
- Experience in billing and insurance.
- Experience with filling out and obtaining insurance authorizations in providers office, retail or inpatient pharmacy.

Apply today!

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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