Medication Access Associate I (64 hours per pay period) - remote

Education Qualifications:

Key Responsibilities:

• Gather necessary insurance information to conduct benefits investigation on prior authorization (PA) requests via a patient’s pharmacy benefits
• Interpret PA and appeal requirements and gather all relevant clinical and supporting documentation for submission to third party payors
• Effectively communicate with providers, nursing staff, pharmacies, third parties, and software vendor to work through claims adjudication and processing issues to ensure payment from third party payers for medications ordered by Essentia providers requiring prior authorization
• Understand Medicare Part B DME billing for Essentia retail pharmacies to help ensure Medicare rules are followed when processing Medicare B billed claims
• Provide direct patient interaction in assisting patient with manufacturer-based Patient Assistance Programs (PAP), serving as a liaison between patients, providers, and pharmaceutical manufacturers

Required Qualifications:

• 1 year experience as a pharmacy technician, medical assistant, claims representative in a managed care role or in a coding role

Preferred Qualifications:

• Excellent verbal and written communication skills
• Attention to detail and ability to manage multiple tasks simultaneously
• 2 years’ experience as a pharmacy technician, medical assistant, claims representative in a managed care role or in a coding role