Remote Acute Care Intake & Authorization Specialist

Soleo Health Inc; United States; Remote; USD 55,000 - 75,000; 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

Paid Parental Leave Options

Affordable Medical, Dental, & Vision

Company Paid Disability & Basic Life

Education Assistance Program

Job summary

Soleo Health Inc. is seeking an Acute Clearance Specialist to process referrals, verify patient eligibility, and manage payer authorizations for our remote infusion services in the United States.

Responsibilities include benefit verification, COI documentation, and coordinating prior authorizations. Ideal candidates have 2+ years in home infusion or medical intake, knowledge of Medicare/Medicaid, and HIPAA compliance. On-call rotation and strong multitasking are required.

Qualifications

• Acute home infusion experience required
• 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

Responsibilities

• Perform benefit verification of patient insurance plans including documenting coverage for medications, administration supplies, and related infusion services
• Document 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

Skills

Home infusion experience

Prior authorization

Benefits verification

Medicare/Medicaid knowledge

HIPAA compliance

Excel

Word

On-call availability

CPR+

Education

High school diploma or equivalent

Tools

CPR+

Job description

Soleo Health Inc. is seeking an Acute Clearance Specialist to process referrals, verify patient eligibility, and manage payer authorizations for our remote infusion services in the United States.

Responsibilities include benefit verification, COI documentation, and coordinating prior authorizations. Ideal candidates have 2+ years in home infusion or medical intake, knowledge of Medicare/Medicaid, and HIPAA compliance. On-call rotation and strong multitasking are required.