Remote Infusion Eligibility & Authorization Specialist

Soleo Health; United States; Remote; USD 42,000 - 60,000; 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

Parental leave options

Insurance plans

Disability & life insurance

Education assistance

Job summary

Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!

The Clearance Specialist will handle referrals, verify eligibility, adjudicate test claims, coordinate benefits, and prepare payer submissions. Must have acute infusion experience, and be able to work 8:30a-5p Mountain Time in a fully remote role.

Qualifications

• High school diploma or equivalent.
• Experience running test claims and calculating HCPC codes.
• At least 2 years in home infusion specialty pharmacy or medical intake/reimbursement.
• Knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.
• Ability to multi-task in a fast-paced environment.

Responsibilities

• Verify patient insurance benefits and document coverage for medications and infusion services.
• Document coinsurance, copays, deductibles, and authorization requirements.
• Calculate estimated patient financial responsibility from benefit verification and payer contracts.
• Initiate and follow up on prior authorization, pre-determination, or medical review.
• Review clinical documents for submission and communicate status to stakeholders.
• Assist enrollment of patients into copay assistance programs when needed.
• Generate new patient start of care paperwork.

Skills

Acute infusion experience

Test claims

HCPC codes

Benefit verification

Prior authorization

HIPAA knowledge

Excel

Word

CPR+ knowledge

Education

High school diploma or equivalent

Tools

Medicare/Medicaid understanding

Job description

Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!

The Clearance Specialist will handle referrals, verify eligibility, adjudicate test claims, coordinate benefits, and prepare payer submissions. Must have acute infusion experience, and be able to work 8:30a-5p Mountain Time in a fully remote role.