Clearance Specialist - Intake Coordinator
Apply NowLocation:
Frisco, TX, US
Company:
Soleo Health Inc is a national provider of specialty pharmacy and infusion services administered at home or alternate care sites.
Summary:
The Clearance Specialist will process new referrals, verify eligibility, and manage payer authorization requests. A minimum of 2 years of home infusion specialty pharmacy experience is required.
Requirements:
Credentials: high school diploma or equivalent
Experience: At least 2 years of home infusion specialty pharmacy required, Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines including ability to interpret payor contract fee schedules based on NDC and HCPCS units
Job Description:
Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!
Must have specialty infusion experience, and work 9:30a-6p Central Time.
Soleo Health Perks:
- Competitive Wages
- 401(k) with a Match
- Referral Bonus
- Paid Time Off
- Great Company Culture
- Annual Merit Based Increases
- No Weekends or Holidays
- Paid Parental Leave Options
- Affordable Medical, Dental, & Vision Insurance Plans
- Company Paid Disability & Basic Life Insurance
- HSA & FSA (including dependent care) Options
- Education Assistance Program
This Position:
The Clearance Specialist is responsible for processing new referrals including but not limited to verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out of pocket costs. They will also be responsible for preparation, submission, and follow up of payer authorization requests. Responsibilities include:
- Perform benefit verification of all patient insurance plans including documenting coverage of medications, administration supplies, and related infusion services
- Responsible to document all information related to coinsurance, copay, deductibles, authorization requirements, etc
- Calculate estimated patient financial responsibility based off benefit verification and payer contracts and/or company self-pay pricing
- Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including
- Reviewing and obtaining clinical documents for submission purposes
- Communicate with patients, referral sources, other departments, and any other external and internal customers regarding status of referral, coverage and/or other updates as needed
- Refer or assist with enrollment any patients who express financial necessity to manufacturer copay assistance programs and/or foundations
- Generate new patient start of care paperwork
Schedule:
- Must be able to work Monday-Friday 9:30a-6p Central Time
- Must have experience with Benefit Verification & Prior Authorization for Specialty Infusions
