Medication Access Coordinator - Medical Billing

Medication Access Coordinator - Medical Billing

Serious Medicine is what we do. Being extraordinary is who we are. Every colleague plays a key role in upholding this promise to our patients and their families.

Shift: First Shift (United States of America)

Position Highlights:

Nebraska Medicine is now taking applications for a talented individual to join us as an Experienced Medication Access Coordinator in our Retail/Specialty Pharmacy department and will focus on medical billing. This position works at our Central Fill location for Nebraska Medicine and the office is located at approx. 114th and Dodge in Omaha, NE as well as having the opportunity to work remotely.

***Home infusion experience is preferred***

The Medication Access Coordinator role is designed for an individual with a minimum of 3 years retail and/or specialty pharmacy insurance experience or a Medicaid/Medicare/Private Pay Insurance professional. The MAC will support the new home infusion location by completing prior authorizations, insurance appeals, and removing any medication access barriers for patients. The skills the MACs have are a hybrid between pharmacy knowledge and clinical support. This is an ideal role for someone with a passion for pharmacy but also one with problem solving skill to advocate solutions for our Nebraska Medicine patients. This is a desk position but a high paced environment where documentation and follow-up skills are imperative.

(Also known as: Medical Billing, Reimbursement Specialist, Pharmacy Advocate, Pharmacy Insurance Tech, Pharmacy Technician, Pharmacy Financial counselor)

Shift:

• Full Time -- 1.0 FTE (80 hours in a pay period)
• Working 8-hour days, Monday Friday with start times between 7:00 AM to 11:00am
• This is a remote position. Employees must reside in either Nebraska or Iowa

Why Work at Nebraska Medicine?

• Together. Extraordinary. Join a team that values your skills, delivering exceptional care through collaboration.
• Leading Health Network: Work with the region's top academic health network, partnering with UNMC to transform lives through education, research, and patient care.
• Dignity and Respect: We value all backgrounds and experiences, reflecting the communities we serve.
• Educational Support: Enjoy up to $5,000/year in tuition assistance, a 35% discount at Clarkson College, and career advancement opportunities with covered educational costs.

Medication Access Coordinator - Medical Billing:

Determine, support, and assist patients, provider teams, and the pharmacy department to overcome barriers to medication access, with focused expertise in third party prior authorization and billing processes for pharmacy benefits. Assist patients within enrollment into grants, assistance programs, and communicate any financial responsibilities. Provide a Face-to Face/virtual beside oriented service that delivers comprehensive fiscal options to patients. Gather and effectively communicate medical and medication histories including diagnosis, test results, lab values, and previous medications to third party. Verify eligibility, pharmacy benefit provisions and support the appeals process.

Required Qualifications:

• Minimum of three years healthcare and/or insurance/third party reimbursement experience.
• High school education or equivalent required.
• Excellent interpersonal skills and the ability to successfully interact with a variety of internal and external customers at all levels required.
• Ability to solve problems independently and must be strongly vested in team management required.
• Ability to multi-task and excel in a dynamic environment required.
• Experience with various computer mainframe, network, web based and payer applications required.
• Must register with the State of NE as a pharmacy technician required.
• Must complete Pharmacy Technician Certification within one year required.

Preferred Qualifications:

• Knowledge of commercial, Medicare B, Medicare D, and Medicaid pharmacy rules and regulations preferred.
• Associate's degree in business, healthcare or related field preferred.
• Bi-lingual preferred.
• Prior Authorization experience in specialty or retail pharmacy preferred.
• 340B knowledge and experience preferred.
• Apexus 340B OnDemand Certificate preferred.
• One year of pharmacy technician experience preferred.

Nebraska Medicine is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, marital status, sex, age, national origin, disability, genetic information, sexual orientation, gender identity and protected veterans' status.