Remote Infusion Benefit & Authorization Specialist

Socket.dev; Frisco (TX); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Competitive Wages

401k Match

Referral Bonus

Paid Time Off

Great Culture

Merit Increases

No Weekends

Parental Leave

Insurance Plans

Disability Insurance

HSA/FSA

Education Assistance

Job summary

Soleo Health is seeking an Acute Clearance Specialist to support our Specialty Infusion Pharmacy and work remotely in the USA. The role focuses on processing referrals, verifying eligibility, and managing payer authorizations.

The candidate will handle benefit verification, test claim adjudication, and calculate patient out-of-pocket costs while ensuring HIPAA compliance. This full-time position requires 2+ years in home infusion and experience with HCPCS, Medicare/Medicaid rules, and strong

Qualifications

• At least 2 years of home infusion pharmacy experience.
• Experience with prior authorizations, benefit verifications, test claims, and HCPCS calculations.
• Knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.
• Ability to multi-task in a fast-paced environment while maintaining accuracy.
• HIPAA compliance and MS Excel/Word familiarity.
• CPR+ is a plus.

Responsibilities

• Process new referrals and verify patient eligibility.
• Prepare, submit, and follow up on payer authorization requests.
• Document coinsurance, copays, deductibles, and authorization requirements.
• Calculate estimated patient financial responsibility based on verifications.
• Communicate with patients and referral sources regarding status.
• Refer patients to copay assistance programs when needed.
• Generate new patient start-of-care paperwork.

Skills

Home Infusion

Prior Authorizations

Benefit Verifications

HCPC Calculations

Payer Communications

CMS/Medicare Knowledge

HIPAA Compliance

Microsoft Excel

Microsoft Word

Education

High School Diploma

Tools

Microsoft Excel

Microsoft Word

Job description

Soleo Health is seeking an Acute Clearance Specialist to support our Specialty Infusion Pharmacy and work remotely in the USA. The role focuses on processing referrals, verifying eligibility, and managing payer authorizations.

The candidate will handle benefit verification, test claim adjudication, and calculate patient out-of-pocket costs while ensuring HIPAA compliance. This full-time position requires 2+ years in home infusion and experience with HCPCS, Medicare/Medicaid rules, and strong