At Payer Matrix, I coordinate access to high-cost specialty medications for self-funded plan members, working with assistance programs, prescriber offices, specialty pharmacies, and plan sponsors until medication is shipped and receipt is confirmed.
I research assistance programs and resolve coverage and access issues, including cases where 340B options overlap with plan billing. I also document member, provider, pharmacy, and payer contacts and case outcomes in the CRM.
Previously, I explained prior authorization status and plan requirements to members and providers at Maxor Plus/ VytleOne, and supported pharmacies with claim denials and 340B billing questions. My earlier pharmacy experience includes compounding non-sterile prescriptions at Palm Beach Pharmaceuticals and processing prescriptions and insurance claims at CVS Pharmacy.
