Offer summary

Qualifications:

1 year experience as a pharmacy technician, medical assistant, claims representative, or in a coding role., Excellent verbal and written communication skills., Attention to detail and ability to manage multiple tasks simultaneously., 2 years’ experience in a related role is preferred..

Key responsabilities:

Facilitate medication prior authorizations via patients’ pharmacy benefits.

Assist in Medicare Part B billing and processing.

Communicate effectively with providers, nursing staff, and pharmacies to resolve claims issues.

Support patient enrollment in financial assistance programs.

Job description

Building Location:

Essentia Health Superior Belknap Pharmacy

Department:

48850 Prior Authorization-Historic (inactive)

Job Description:

Medication Access Associates work cross-functionally to ensure that patients are receiving the medication therapy they need to achieve optimal care. Primary responsibility will be to facilitate medication prior authorizations via patients’ pharmacy benefits, assist in Medicare Part B billing and processing, and support patient enrollment in financial assistance programs.

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

Licensure/Certification Qualifications:

Licensure/Certifications not required

FTE:

0.8

Possible Remote/Hybrid Option:

Remote

Shift Rotation:

Day Rotation (United States of America)

Shift Start Time:

0800

Shift End Time:

1630

Weekends:

Holidays:

Call Obligation:

Union:

Union Posting Deadline:

Compensation Range:

$21.49 - $32.24

Employee Benefits at Essentia Health*:

Health Coverage: Medical, dental, vision, life and disability insurance, plus supplemental health benefit options to ensure employees' well-being.
Retirement Savings Plans: 401(k) with employer contributions to support long-term financial security.
Professional Development: Opportunities for career growth through training, tuition reimbursement, and educational programs.
Work-Life Balance: Flexible scheduling, time off, holidays, and personal leave to help employees manage their professional and personal lives.
Employee Wellness Programs: Initiatives focused on physical, mental, and emotional health, including fitness memberships, counseling services, and wellness activities.

*Eligibility for Essentia Health’s benefit programs vary. Please refer to the benefit summary provided to you, or contact our HR Service Center at (218) 576-0000 for more information.

Required profile