Acute Clearance Specialist - Intake Coordinator - Remote

Soleo Health; Frisco (TX); Remote; USD 32,000 - 37,000; Full time

Benefits offered by this job

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保险

Company Paid Disability & Basic Life

HSA & FSA Options

Education Assistance Program

Job summary

Soleo Health is seeking an Acute Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). The role processes referrals, verifies eligibility, handles test claim adjudication, and coordinates benefits while estimating out-of-pocket costs. On-call rotation is required every 3-4 weeks.

We prefer candidates with acute infusion experience, strong payer knowledge, and the ability to navigate Medicare/Medicaid guidelines in a fast-paced remote setting.

Qualifications

• High school diploma or equivalent.
• 2+ years in home infusion specialty pharmacy or medical intake/reimbursement experience preferred.
• Knowledge of Medicare, Medicaid and managed care reimbursement guidelines.
• Ability to multitask in a fast-paced environment.
• HIPAA regulations knowledge.
• MS Excel and Word skills.
• CPR+ knowledge preferred.

Responsibilities

• Verify patient eligibility and coordinate benefits for new referrals.
• Perform benefit verification and document coinsurance, copays, and deductibles.
• Calculate estimated patient financial responsibility based on benefit verification and payer contracts.
• Prepare, submit, and follow up on payer authorizations and prior authorizations.
• Communicate with patients and referral sources regarding status.
• Assist enrollment for copay assistance programs when needed.
• Generate start of care paperwork.

Skills

Multitasking

Education

High school diploma or equivalent

Tools

Microsoft Excel

Microsoft Word

Job description

Job Type

Full-time

Description

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

Acute Home Infusion Experience Required

Must be able to work Full Time, 8:30am-5pm Central plus on-call every 3-4 weeks.

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

• Full Time, 40 hours per week, Monday-Friday, 8:30am-5pm Central Time
• Weekend on-call every 3-4 weeks
• Must have experience with Acute Infusion for Prior authorization/Benefits Verification

Requirements

• High school diploma or equivalent
• 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

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.

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Salary Description

$23.00-$27.00 per hour