Ambulatory Medication Access Coordinator – Pharmacy Tech, Prior Authorization and Pharmacy Call[...]

UChicago Medicine; Burr Ridge (IL); Hybrid; USD 55,000 - 70,000; Full time

Benefits offered by this job

Sign-on bonus up to $3,000

Hybrid schedule

Job summary

UChicago Medicine is seeking an Ambulatory Medication Access Coordinator for the DCAM Outpatient- Mail Order Pharmacy-Burr Ridge. You will handle third-party insurance prior authorizations for high-cost medications and support efficient patient and clinic workflows.

Responsibilities include screening patients for payment options, enrolling in patient assistance programs, and coordinating with pharmacists and clinicians to minimize treatment delays.

Qualifications

• Associate or Bachelor’s degree required.
• Current Illinois Pharmacy Technician licensure or eligibility.
• 3–5 years of pharmacy technician experience in retail pharmacy.
• Strong computer skills including word processing and spreadsheets.
• Excellent verbal and written communication abilities.
• Ability to resolve conflicts and work with diverse teams.
• Comfortable in a fast-paced environment with competing priorities.
• Knowledge of insurance carrier/managed care reviews.

Responsibilities

• Improve patient service experience and maximize revenue through prior authorization services for high-cost meds.
• Screen patients for insurance, benefits, and financial assistance; complete prior authorization forms.
• Coordinate enrollment in patient assistance programs with social services and case management.
• Enter patient data into tracking forms and systems.
• Support clinic workflow by preventing therapy interruptions due to insurance issues.
• Provide exemplary customer service to outpatients in ambulatory care.
• Monitor prescribing trends to identify contracting improvement opportunities.
• Help develop policies ensuring reimbursement of high-cost medications.
• Perform other duties as requested by senior management.

Skills

Pharmacy technician experience

Customer service

Communication skills

Computer literacy

Insurance billing knowledge

Team collaboration

Adaptability

Education

Associate or Bachelor’s degree

Tools

Microsoft Excel

Word processing

Database management

Job description

Be a part of a world-class academic healthcare system at

Be a part of a world-class academic healthcare system at UChicago Medicine as an Ambulatory Medication Access Coordinator in the DCAM Outpatient- Mail Order Pharmacy-Burr Ridge. In this role you will be responsible for assistance with conducting and completing necessary third party (insurance) prior authorization requests and associated services related to high cost medications, maximizing efficiency for patients and clinic staff. UChicago Medicine Duchossois Center for Advanced Medicine - Hyde Park, also known as DCAM, is our flagship outpatient facility and is home to dozens of primary and specialty clinics as well as a pharmacy.

Eligible for a Sign-On Bonus up to $3,000

In this role, the Ambulatory Medication Access Coordinator, or AMAC, performs necessary functions to ensure optimal reimbursement for high cost, take home medications for patients receiving care in UCMC ambulatory clinics. Other areas of responsibility include pre-screening patients for viable payment sources, managing reimbursement issues associated with high cost take-home medications, identifying opportunities for improving reimbursement from payers, compiling reports for contract optimization, completing the necessary paperwork for prior authorizations, and conducting retrospective utilization reviews on cases of payment denials or insufficient reimbursement

Essential Job Functions

• Improve patient service experience and maximize UCMC pharmacy revenue through provision of prior authorization services on behalf of clinics for select high cost medications.
• Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete prior authorization forms, negotiate authorization status with insurers, track status of prescription approval and when necessary, alert clinical pharmacists of denials or nonresponse.
• Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance.
• Enter patient information on tracking forms and in computer software.
• Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff.
• Provide exemplary customer service to outpatients across UCMC.
• Observe and understand prescribing trends within UCMC ambulatory clinics to identify areas for improved specialty pharmacy contracting.
• Assist with the development and implementation of policies and procedures to ensure reimbursement of high cost medications.
• Performs other duties as requested by senior management.

Required Qualifications

• Associate or Bachelor’s degree
• Current or Eligibility for Illinois Pharmacy Technician Licensure
• 3 to 5 years of pharmacy technician experience in a retail pharmacy (Exceptional aptitude or knowledge may be considered in lieu of experience.)
• Knowledge of and ability to use computers and a variety of computer programs including word processing, database management and spreadsheets
• Strong oral and written communications skills
• Ability to effectively manage conflicts and resolve problems
• Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction
• Ability to function effectively in a fast-paced and changing environment with multiple priorities
• Knowledge of and ability to perform insurance carrier/managed care review

Preferred Qualifications

• Knowledge of medication reimbursement preferred
• Knowledge of healthcare/prescription insurance billing, prior authorization, coding preferred

Position Details

• Job Type/FTE: Full-Time (1.0 FTE) Hybrid
• Shift: 9am-5:30pm
• Unit/Department: Outpatient Pharmacy
• CBA Code: Non-Union

In this role, we anticipate that you will be scheduled to work the day shift, you will approximately work 9am-5:30pm, and will not be scheduled for on-call shifts. We anticipate you will work a hybrid schedule, with onsite shifts at the Burr Ridge location after 90 days of hire. The days of the week that you are scheduled will be Monday-Friday, and no weekends.

About Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities

UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

As a condition of employment, all employees are required to complete a pre-employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law.

Compensation & Benefits Overview

UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position. The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union. Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.