Remote Infusion Clinical Review Coordinator

Soleo Health; Frisco (TX); Remote; USD 65.000 - 80.000; Vollzeit

Benefits dieser Stelle

Competitive Wages

Flexible schedules

401(k) with a match

Referral Bonus

Paid Time Off

Annual Merit Based Increases

No Weekends or Holidays

Affordable Medical, Dental, and Vision

Company Paid Disability and Basic Life

HSA and FSA (including dependent care)

Education Assistant Program

Zusammenfassung

Soleo Health is seeking an Infusion Clinical Review Coordinator to support our Specialty Infusion Pharmacy. This role works remotely (USA) with standard Monday-Friday hours 8:30am-5pm MST or PST, focusing on clinical reviews for complex patient cases and denials management.

Responsibilities include prior authorization reviews, documentation for appeals, and staying current on payer policies. The position requires infusion pharmacy experience and may involve cross-department collaboration.

Qualifikationen

• Preferred qualifications are Medical Assistant, LPN, RN.
• Experience with specialty infusion pharmacy required.
• Bachelor’s degree in healthcare field or 3 years in a qualified position.

Aufgaben

• Completes prior authorization reviews evaluating patient clinicals and payer criteria to determine medical necessity.
• Reviews patient progress notes, lab reports, infusion summaries, imaging reports, and plan of care to satisfy payer policies.
• Requests additional clinical information when needed to render a decision and determine next steps.
• Assists with creation of clinical support packets for initial prior authorization and appeals.
• Documents succinct clinical cases to support appeals using medical necessity criteria.
• Maintains a library of clinical support resources including templates for appeals and journal articles.

Kenntnisse

Medical Assistant

LPN

RN

Ausbildung

Bachelor’s degree in healthcare field or 3 years in a qualified position

Jobbeschreibung

Soleo Health is seeking an Infusion Clinical Review Coordinator to support our Specialty Infusion Pharmacy. This role works remotely (USA) with standard Monday-Friday hours 8:30am-5pm MST or PST, focusing on clinical reviews for complex patient cases and denials management.

Responsibilities include prior authorization reviews, documentation for appeals, and staying current on payer policies. The position requires infusion pharmacy experience and may involve cross-department collaboration.