Ambulatory Medication Access Coordinator (Full-Time): Days

Job Description

Be a part of a world-class academic healthcare system at UChicago Medicine as an Ambulatory Medication Access Coordinator for the Infusion Pharmacy team .

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.

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Job Summary

In this role, the Ambulatory Medication Access Coordinator, or AMAC, performs necessary functions to ensure optimal reimbursement for high cost medications for patients receiving care in UCMC ambulatory clinics and infusion centers.

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.

This specific role will focus on enrolling patients into assistance programs to reduce costs for chemotherapy and biologic infusion therapy and injections.

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 experience in a retail pharmacy or revenue cycle role (Exceptional aptitude or knowledge may be considered in lieu of
• 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)
• Shift : Rotate 8 hour shift / Days
• Work Location : Hyde Park
• Unit / Department : Infusion Pharmacy
• CBA Code : Non-Union

In this role, we anticipate that you will be scheduled to work the day shift, you will approximately work 8am-4 : 30pm, and will not be scheduled for on-call shifts.

We anticipate you will be scheduled to work mostly remote with specific on-site days at the Hyde Park campus. The days of the week that you are scheduled will be Monday-Friday, and no weekends.