Medication Access Advocate, First shift, Pharmacy Administration at UC HEALTH LLC in Cincinnati, Ohio

Job Description:

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.

Verification of insurance coverage utilization different on-line modalities for clinic patients receiving medications and chemotherapy. The associate is responsible for obtaining prior authorization requests and/or pre-determination for these services to ensure maximum reimbursement to the organization. The associate will initiate or facilitate enrollment in philanthropic foundation or manufacturer-based assistance programs if patients do not have insurance coverage for medications and chemotherapy.Minimum required: High School Diploma or GED. | 1 - 2 Years equivalent experience. Preferred: 3-5 years equivalent experienceJob Function: 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.

Job Function: Leverage Patient Assistance Programs
• Ensures authorization or access through assistance programs has been obtained for all high dollar medications.

Job Function: 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.

Job Function: Worklists
• Effectively organizes prioritization of Daily Worklist task.

Job Function: Secure Accounts
• Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards.

Job Function: Communication
• Reports improvements, problems, and changes as it relates to insurance verification to department management

Job Function: Other duties as assigned
• Performs other duties as assignedJob Function: 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.

Job Function: Leverage Patient Assistance Programs
• Ensures authorization or access through assistance programs has been obtained for all high dollar medications.

Job Function: 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.

Job Function: Worklists
• Effectively organizes prioritization of Daily Worklist task.

Job Function: Secure Accounts
• Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards.

Job Function: Communication
• Reports improvements, problems, and changes as it relates to insurance verification to department management

Job Function: Other duties as assigned
• Performs other duties as assigned