Patient Financial Counselor - Pharmacy

A cover letter is required for consideration for this position and should be attached as the first page of your resume. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position.

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Basic Function and Responsibility

This 1.0 FTE position is dedicated to 100% patient care as a pharmacy financial coordinator within the pharmacy program. This position reports directly to the PFC Supervisor.

Characteristic Duties and Responsibilities

The patient financial coordinator (PFC) will coordinate medication access and financial assistance for Michigan Medicine pharmacy patients. This includes performing pharmacy insurance benefit investigations; completing pharmacy prior authorizations (PAs); coordinating prescription drug appeals; coordinating medication financial assistance enrollment (copay cards, patient assistance programs, etc) for eligible patients; assisting in the miscellaneous coordination and follow up with providers and MM pharmacy to ensure timely access to medication therapy.

Core functions include

• Obtaining detailed prescription insurance information to adjudicate claims.
• Communicate complex pharmacy benefit insurance and financial information relating to specialty and non-specialty medications to patients and internal and external customers, as appropriate.
• Evaluate patient-specific medication, insurance, and financial situations and provide counseling relating to coverage terms, benefits, and related requirements.
• Submit prior authorizations for medication coverage through pharmacy and/or medical insurance.
• Assist eligible patients in navigating access to manufacturers and extended coverage options.
• Troubleshoot and resolve complex pharmacy benefit billing issues associated with specialty and non-specialty medications.
• Identify, develop, and implement additional quality improvement initiatives to improve the team?s efficiency to decrease turnaround time for patient access to medication.

• Graduation from high school or equivalent of education and experience.
• Minimum of 3-5 years prior authorization experience through pharmacy and/or medical benefit with progressive levels of responsibility.
• Strong knowledge of medical and/or prescription insurance policies and requirements, with the ability to accurately interpret and confidently explain insurance benefits and coverage details to diverse audiences.
• Ability to work in a fast-paced environment, consistently problem solving and managing time in an efficient and productive manner.
• Ability to work well as part of a team with minimal supervision.
• Ability to manage time-sensitive information while maintaining strict patient confidentiality.
• Excellent written and verbal communication skills.

• Bachelor's or associate degree in a healthcare-related field.
• Analytical and computing skills with Word and Excel programs.
• Experience with Epic and/or other billing and pharmacy dispensing programs.
• Ability to perform a variety of manual dexterity movements, including keyboarding; fluency in reading, writing and speaking English.
• Ideal candidate must be patient-centered, flexible, adaptable to change, innovative, and willing to take on tasks/responsibilities with autonomy and creativity as we are a growing program and the working environment will continue to change.

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world's most distinguished academic health systems.

In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

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