Medication Access Advocate, First shift, Pharmacy Administration
- Req. Number: 17671
- City, State: OH, IN, KYRemote - IN, KY, OH
- Job Type: Full time
- Posted Date: 3/5/2025
Job Description
Location: UC Health Business Center / Remote
Department: Medication Access Services, Pharmacy
Hours: 0800-1630
Shift: First
UC Health is hiring a Full-time, Medication Access Advocate in Pharmacy Administration at University of Cincinnati's Medical Center.
This position is for medication denials follow up. Qualified candidates will have experience in health-system pharmacy, revenue cycle, or both. It involves verification of insurance coverage utilization different on-line modalities for clinic patients receiving medications and chemotherapy through medical billing. The associate is responsible for reviewing and trouble-shooting denied accounts, assessing prior authorization requests and/or pre-determination for these services, and submitting appeals to minimize revenue loss to ensure maximum reimbursement to the organization.
About University of Cincinnati Medical Center
As part of the Clifton Campus of UC Health, Greater Cincinnati's academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200 years. Each year, hundreds of thousands of patients receive care from our world-renowned clinicians and care team. Our experts utilize the most advanced medical knowledge and technology available, providing a level of specialty and subspecialty medical care that is not available anywhere else in Greater Cincinnati
Unit Details:
Responsibilities
Insurance Verification:
• Initiates on-line verification and/or makes phone contact with Insurance Carriers and Plan Administrators to verify patient benefits to pre-certify that all outpatient services are secure.
• Follows up on missing data or problem accounts.
Leverage Patient Assistance Programs:
• Ensures authorization or access through assistance programs has been obtained for all high dollar medications.
Documentation:
• Documents complete and accurate data relating to all necessary eligibility, enrollment, benefits and precertification information in appropriate Epic database fields.
• Informs management of trends of incomplete data, registration issues, etc.
Worklists:
• Effectively organizes prioritization of Daily Worklist task.
Secure Accounts:
• Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards.
Communication:
• Reports improvements, problems, and changes as it relates to insurance verification to department management
Other duties as assigned:
• Performs other duties as assigned
Qualifications
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
The expected starting salary range for this position is between $17.23/hr.- $21.78/hr.
The actual pay rate for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, alignment with similar internal candidates, marketplace factors, and other requirements for the position.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.
UC Health is committed to providing an inclusive, equitable and diverse place of employment.
Location: UC Health Business Center / Remote
Department: Medication Access Services, Pharmacy
Hours: 0800-1630
Shift: First
UC Health is hiring a Full-time, Medication Access Advocate in Pharmacy Administration at University of Cincinnati's Medical Center.
This position is for medication denials follow up. Qualified candidates will have experience in health-system pharmacy, revenue cycle, or both. It involves verification of insurance coverage utilization different on-line modalities for clinic patients receiving medications and chemotherapy through medical billing. The associate is responsible for reviewing and trouble-shooting denied accounts, assessing prior authorization requests and/or pre-determination for these services, and submitting appeals to minimize revenue loss to ensure maximum reimbursement to the organization.
About University of Cincinnati Medical Center
As part of the Clifton Campus of UC Health, Greater Cincinnati's academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200 years. Each year, hundreds of thousands of patients receive care from our world-renowned clinicians and care team. Our experts utilize the most advanced medical knowledge and technology available, providing a level of specialty and subspecialty medical care that is not available anywhere else in Greater Cincinnati
Unit Details:
- Medical, Dental, and Vision Insurance
- Employee Paid Short- and Long-Term Disability
- 401K
- Tuition Reimbursement Opportunities
- Community Discounts
- First shift Monday-Friday
- No nights, no weekends, no holidays
- Remote position
Responsibilities
Insurance Verification:
• Initiates on-line verification and/or makes phone contact with Insurance Carriers and Plan Administrators to verify patient benefits to pre-certify that all outpatient services are secure.
• Follows up on missing data or problem accounts.
Leverage Patient Assistance Programs:
• Ensures authorization or access through assistance programs has been obtained for all high dollar medications.
Documentation:
• Documents complete and accurate data relating to all necessary eligibility, enrollment, benefits and precertification information in appropriate Epic database fields.
• Informs management of trends of incomplete data, registration issues, etc.
Worklists:
• Effectively organizes prioritization of Daily Worklist task.
Secure Accounts:
• Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards.
Communication:
• Reports improvements, problems, and changes as it relates to insurance verification to department management
Other duties as assigned:
• Performs other duties as assigned
Qualifications
- Education: Minimum Required: High School Diploma or GED
- Years of Experience: Minimum Required: 1 - 2 Years equivalent experience completing Pre-certifications/prior authorizations in a hospital setting, medical office setting, Patient Access or similar environment. Preferred: 3 - 5 Years equivalent experience completing Pre-certifications/prior authorizations in a hospital setting, medical office setting, Patient Access or similar environment. Pharmacy/medication experienced preferred but not required.
- Required Skills and Knowledge: Ability to perform work accurately with attention to detail within specified time periods; work cooperatively with health-system and pharmacy staff; handle frequent interruptions and adapt to changes in workload and work schedule; set priorities and solve problems; respond quickly to emergency requests; communicate effectively (orally and in writing), and assist in meeting the pharmaceutical care needs of the patient populations served by the organization.
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
The expected starting salary range for this position is between $17.23/hr.- $21.78/hr.
The actual pay rate for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, alignment with similar internal candidates, marketplace factors, and other requirements for the position.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.
UC Health is committed to providing an inclusive, equitable and diverse place of employment.
