Clearance Specialist - Intake Coordinator

Soleo Health; Texas; On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Competitive Wages

401(k) with a Match

Referral Bonus

Paid Time Off

Affordable Medical, Dental, & Vision Insurance

Paid Parental Leave Options

Company Paid Disability & Basic Life Insurance

Education Assistance Program

Job summary

Soleo Health, Inc. is seeking a Specialty Clearance Specialist to support our Specialty Infusion Pharmacy. This remote position requires acute home infusion experience and the ability to work full-time, Monday-Friday.

Responsibilities include verifying patient eligibility, securing prior authorizations, and communicating with patients and referral sources. We offer competitive wages and several employee perks, including 401(k) matching, paid time off, and health insurance.

Qualifications

• At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred.
• Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met.
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.

Responsibilities

• Verify patient eligibility for insurance plans.
• Document all information related to coinsurance, copay, deductibles, and authorization.
• Calculate estimated patient financial responsibility based on benefit verification.
• Initiate and secure prior authorization, pre-determination, or medical review.
• Communicate with patients, referral sources, and internal departments on status updates.

Skills

Acute home infusion experience

Multi-tasking

Knowledge of HIPAA regulations

Basic Microsoft Excel & Word skills

Education

High school diploma or equivalent

Tools

CPR+

Job description

Description

Soleo Health is seeking a Specialty 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 9am-5:30pm Central Time or 8am-4:30pm Eastern Time and on-call once every 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:

• Must be able to work Full time, 40 hours per week, Monday-Friday
• 9am-5:30pm Central Time or 8am-4:30pm Eastern Time
• Weekend on-call once every 4 weeks
• Must have experience with Acute Infusion for Prior authorization/Benefits Verification

Requirements

• , cleHigh 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.