Medication Access Technician

UCSF•San Francisco, CA

1d•$42 - $53

About The Position

Under the supervision of the Medication Access Manager and guided by the policies and procedures of Ambulatory and Outpatient Pharmacy Services, the Pharmacy Medication Support Specialist facilitates prescription prior authorization and refill requests. The role obtains, prepares, and submits forms for insurance authorizations; requests information from insurance companies about possible alternative therapies; and communicates timely status updates to patients. It also facilitates medication refill requests by evaluating them against refill protocol criteria, reviewing patient medical records in APeX, and contacting patients for needed information. The specialist conducts medication benefits investigations, explores financial assistance options where applicable, and serves as the primary contact for medication authorization and refill requests. The position facilitates prior authorizations and financial assistance, processes and evaluates refill requests, documents activity in APeX, and supports pharmacy operations through training, quality improvement, and required training. The role requires flexibility to orient and work at all UCSF Medical Center locations.

Requirements

Complete a recognized or accredited Pharmacy Technician Training Program.
Have at least three years of experience as a Pharmacy Technician or allied healthcare professional in a hospital, pharmacy, or other healthcare setting, or an equivalent combination of education and experience.
Hold a Pharmacy Technician license from the California Board of Pharmacy and be in good standing.
Have strong computer skills, including proficiency in Microsoft Office.
Be able to prioritize work efficiently.
Have excellent interpersonal communication and writing skills and be able to work effectively with a large, diverse population, including maintaining good relationships between the Pharmacy and Ambulatory Clinics.
Have excellent organizational and problem-solving skills.
Be able to multitask and remain flexible when work assignments change at short notice.
Have basic math skills.
Be flexible to orient and work at all UCSF Medical Center locations.

Nice To Haves

Recent experience processing third-party billing, including prior authorization facilitation and refill authorization.
Bilingual ability in Spanish, Cantonese, and/or Russian.
Bachelor’s degree in health or behavioral science.
Medical Assistant Certification.
Ability to use an EMR and perform chart abstraction into the EMR, specifically APeX.
Adaptability and willingness to learn new technologies, including AI solutions.

Responsibilities

Drive prior authorization processes to completion under pharmacist oversight and resolve related issues.
Investigate medication benefits and submit prior authorizations to insurers manually, electronically, or by telephone as needed.
Notify patients of prior authorization and financial assistance status and document that status in APeX.
Follow up with health insurance payors that do not respond to submitted prior authorization requests.
Work with pharmacists or providers on denials and appeals.
Evaluate patient assistance program opportunities when necessary.
Receive and process refill requests from clinic personnel, pharmacies, and patients.
Evaluate refill requests against protocol criteria by reviewing APeX and contacting patients as needed.
Notify pharmacists when specific refill protocol criteria are not met.
Note when a provider appointment is needed, where applicable.
Discuss recommendations and other pertinent information with the pharmacist.
Search for required lab tests, review the EMR for needed tests, document the need, and inform patients about needed labs when appropriate.
Pend an order or provider appointment request in APeX based on pharmacist judgment.
Document each refill request in the patient’s chart.
Assist with training and onboarding staff and learners on refill and prior authorization processes.
Participate in the pharmacy’s continuous quality improvement activities.
Complete training requirements on time and stay current on policies and procedures.
Perform additional pharmacy operations and patient care tasks as deemed appropriate or necessary by the supervisor or manager.