Patient Financial Counselor - Pharmacy

Pharmacy Financial Coordinator

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.

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 pharmacy 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 of prior authorization experience through pharmacy benefit with progressive levels of responsibility. Knowledge of medical and prescription insurance company policies and requirements (i.e. Medicare, Social Security, Medicaid, and Medicare Part D). 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. Excellent customer service 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 30,000 employees 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.

What Benefits can you Look Forward to?

• Excellent medical, dental and vision coverage effective on your very first day
• 2:1 Match on retirement savings

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

This position is covered under the collective bargaining agreement between the U-M and the Service Employees International Union (SEIU), which contains and settles all matters with respect to wages, benefits, hours, and other terms and conditions of employment.

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.