Remote Prior Authorization Coordinator - Specialty Pharmacy

Paylocity; United States; On-site; USD 52,000 - 78,000; 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 is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work remotely in the United States. The role focuses on maintaining prior authorizations, copay assistance, and verifying insurance coverage for ongoing services.

Responsibilities include obtaining detailed benefit information, processing test claims, generating expiration reports, and coordinating with prescribers and patients to resolve delays.

Qualifications

• Soleo Health requires at least 2 years of home infusion specialty pharmacy experience with prior authorizations, test claims and HCPCS calculations.
• Experience verifying insurance coverage and understanding benefit structures is essential.
• Ability to manage multiple priorities in a dynamic environment.

Responsibilities

• Maintain prior authorizations, copay assistance and verification of benefits for ongoing services.
• Verify insurance benefit information monthly using online tools, payor calls or test claims processing.
• Generate a prior authorization expiration report on a regular schedule (weekly/biweekly/monthly).
• Review clinical documents for pre-determination and submission purposes.
• Coordinate with prescribers and patients to obtain required information for re-authorization and benefit verification.
• Notify patients of financial responsibility, coverage and payor authorization for services.

Skills

Specialty home infusion experience

Prior authorization experience

Insurance knowledge

Communication skills

Education

High school diploma or equivalent

Tools

HCPCS calculations

NDC pricing

Test claims processing

Job description

Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work remotely in the United States. The role focuses on maintaining prior authorizations, copay assistance, and verifying insurance coverage for ongoing services.

Responsibilities include obtaining detailed benefit information, processing test claims, generating expiration reports, and coordinating with prescribers and patients to resolve delays.