Acute Clearance Specialist - Intake Coordinator - Remote

Soleo Health; United States; Remote; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive Wages

401(k) Match

Referral Bonus

Paid Time Off

Great Company Culture

Merit Increases

Paid Parental Leave

Insurance Plans

Disability Insurance

Education Assistance

Job summary

Soleo Health is seeking an Acute Clearance Specialist to support our Specialty Infusion Pharmacy and operate remotely across the USA. The role focuses on eligibility verification, coordinating benefits, and securing prior authorizations for infusion therapies.

Ideal candidates have acute home infusion experience, strong payer knowledge, and the ability to manage multiple referrals in a fast-paced setting while complying with HIPAA and company policies.

Qualifications

• High school diploma or equivalent.
• 2+ years in home infusion pharmacy or medical intake/reimbursement preferred.
• Knowledge of Medicare/Medicaid and managed care reimbursement guidelines.
• Ability to multi-task and maintain productivity in a fast-paced environment.
• HIPAA compliance knowledge.

Responsibilities

• Verify patient insurance benefits and coverage for medications, administration supplies, and infusion services.
• Document coinsurance, copays, deductibles, and authorization requirements.
• Calculate estimated patient financial responsibility based on benefits and contracts.
• Initiate and follow up on prior authorizations, pre-determination, or medical reviews.
• Review clinical documents for submission and communicate status to stakeholders.
• Assist enrollment for patients needing copay assistance programs when applicable.
• Prepare new patient start-of-care paperwork.

Skills

Acute infusion experience

Benefits verification

Prior authorization

Medicare/Medicaid knowledge

HIPAA compliance

Microsoft Excel

Communication

Multi-tasking

Education

High school diploma or equivalent

Tools

Microsoft Word

Job description

All Jobs > Acute Clearance Specialist - Intake Coordinator - Remote

Acute Clearance Specialist - Intake Coordinator - Remote
Fully Remote Fully Remote

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

• Competitive Wages
• 401(k) with a Match
• Referral Bonus
• Paid Time Off
• Great Company Culture
• Annual Merit Based Increases
• Paid Parental Leave Options
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• 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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