Prior Authorization Medication Coordinator (Medical Assistant)

Required Skills & Experience

REQUIREMENTS:

• High school diploma or GED required.
• Minimum 6 months experience evaluating insurance eligibility and handling prior authorizations (including both commercial and public health benefits).
• Current Medical Assistant certificate OR Pharmacy Tech certification
• Certification upon hire date or within 90 days of hire through o Pharmacy Technician Certification Board (PTCB) or Exam for the Certification of Pharmacy Technician (ExCPT) required. o Certification required to pass 90 day probationary period.

Nice to Have Skills & Experience

Plusses:

• Medical Assistant Certification through American Association of Medical Assistants (CMA/AAMA), National Healthcareer Association (CCMA), American Medical Technologists (RMA), or National Center for Competency Testing (NCMA) is a plus.
• Experience working in a nonprofit ASO environment a plus
• specific training/experience with HIV/AIDS-related health issues a plus.
• Knowledge and experience working with the LGBTQ community

Job Description

Hiring a Medication Coordinator (Medical Assistant) for a community health clinic in Los Angeles 90016.

The Medication Coordinator (Medical Assistant) will process and track all request for refills, prior authorizations, and patient assistance program while onsite 5 days a week in Los Angeles 90016.

Schedule: Mon - Friday 8 to 5

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Obtain prior authorizations (PA) for medications. Contact insurance carriers to verify medication eligibility and requirements. Request, track and obtain prior authorizations from insurance carriers. Facilitate appeals as needed. Request, and track medications requested via the patient assistance program. Communicate any insurance changes or trends among the team. Provide updates to local, state, & federal benefits. Gather feedback as provided and relay to program leads. Clearly document all communications and contacts with insurance companies, PBOs and pharmacies. Stay up to date on all avenues of medication access for patients, including public benefits and programs that may serve as payers of last resort. Evaluate patient candidacy appropriately. Facilitate enrollment of qualifying patients, coordinating with other team members if necessary. Complete and manage forms/applications to process medications via the Patient Assistant Program, delegate as appropriate. Maintain patients informed on status of patient assistance program, PAs approvals or denials and document in patients electronic health record. Process refill medications request Provide medication information and education to patients, following established protocols and guidelines.