Medication Access Technician

University of California, San Francisco•San Francisco, CA

About The Position

UCSF Medical Center is a patient-centered organization committed to enhancing health and well-being through patient care, research, and education, with a culture grounded in collaboration, excellence, leadership, respect, professionalism, integrity, and diversity. Under the supervision of the Medication Access Manager and guided by Ambulatory and Outpatient Pharmacy Services policies and procedures, the Pharmacy Medication Support Specialist facilitates prescription prior authorizations and refill requests. The role obtains, prepares, and submits insurance authorization materials; requests information from insurers about possible alternative therapies; and communicates authorization status to patients in a timely manner. It also evaluates refill requests against established protocols by reviewing medical records in APeX and contacting patients for needed information. The specialist performs medication benefits investigations, explores financial assistance options where applicable, and serves as the primary contact for medication authorization and refill requests.

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.
Be licensed as a Pharmacy Technician by 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 the ability to work effectively with a large, diverse population while 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 electronic medical record and perform chart abstraction into the EMR, specifically APeX.
Adaptability and willingness to learn new technologies, including AI solutions.

Responsibilities

Drive prior authorization requests to completion under pharmacist oversight, resolve related issues, and submit requests accurately to insurance companies manually, electronically, or by telephone.
Perform medication benefits investigations and evaluate patient assistance program opportunities when necessary.
Notify patients of prior authorization and financial assistance status and document this information in APeX.
Follow up with insurance payors that have not responded to submitted prior authorization requests.
Work with pharmacists or providers on denials and appeals.
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 refill protocol criteria are not met and discuss recommendations and other pertinent information.
Identify needed provider appointments and laboratory tests, review the electronic medical record for required labs, and inform patients about needed labs when applicable.
Pend orders or provider appointment requests in APeX based on pharmacist judgment and properly 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 program.
Complete training requirements promptly 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.