Remote Acute Care Benefits Verifier & PA Specialist

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

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.