Clearance Team Lead

Soleo Health; Teletrabalho; BRL 120.000 - 160.000; Tempo integral

Resumo da oferta

A healthcare provider is seeking a Clearance Team Lead to join their Specialty Infusion Pharmacy team. This remote role requires expertise in home infusion and reimbursement processes. Key responsibilities include providing guidance to the Patient Access team, managing workflow, handling escalations, and generating reports. The ideal candidate will have a strong background in specialty infusion services and a customer service orientation, with knowledge of Medicare, Medicaid, and HIPAA regulations. Competitive wages and various perks are offered.

Serviços

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 Options

Education Assistance Program

Qualificações

• At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred.
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.
• Ability to work in a fast-paced environment.

Responsabilidades

• Provide guidance to the team on referral processing standards.
• Monitor and assign referral workload.
• Handle escalations and provide exceptional customer service.
• Support Patient Access team members and provide necessary guidance.
• Generate and update patient access-related reports.

Conhecimentos

Home infusion specialty pharmacy experience

Multi-tasking

Customer service

Knowledge of HIPAA regulations

Microsoft Excel & Word

Formação académica

High school diploma or equivalent

Ferramentas

CPR+

Descrição da oferta de emprego

Description

Soleo Health is seeking a Clearance Team Lead to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!

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

The Position:

The Clearance Team Lead provides daily support and guidance to the Patient Access team, assists with escalations, participates in complex therapy benefit verification and prior authorization submissions, and performs duties of both the Clearance Specialist and Prior Authorization Coordinator. They work closely with the Patient Access Supervisor to ensure the team meets or exceeds productivity and quality expectations while delivering exceptional patient care.

Responsibilities include:

• Acts as a resource for colleagues: Provide guidance to the team on referral processing standards, Soleo contracts, fee schedules, therapy guidelines, and supported therapies
• Monitor and assign referral workload: Oversee the clearance team’s workload and direct the work of other staff members
• Serve as a Subject Matter Expert: Works autonomously to handle more complex issues related to benefits and authorization within established procedures and practices
• Handle escalations: Provide exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner
• Assist in training new team members: Ensure new team members understand their roles and responsibilities and provide ongoing training to enhance their skills and knowledge
• Support Patient Access team members: Provide necessary guidance, feedback and counseling and may contribute input for performance evaluations
• Generate and update reports: Create, update and distribute patient access-related reports as needed
• Perform duties of a Clearance Specialist and Prior Authorization Coordinator

Schedule:

• Monday-Friday 8:30-5p
• Must have experience with Specialty Infusion for Prior authorization/Benefits Verification
• Prefer someone with training or lead experience

Requirements

• At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines including ability to interpret payor contract fee schedules based on NDC and HCPCS units
• Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met
• Ability to work in a fast-paced environment
• Knowledge of HIPAA regulations
• Basic level skill in Microsoft Excel & Word
• Knowledge of CPR+ preferred
• High school diploma or equivalent

About Us:

Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

Soleo’s Core Values:

• Improve patients’ lives every day
• Be passionate in everything you do
• Encourage unlimited ideas and creative thinking
• Make decisions as if you own the company
• Do the right thing
• Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.