Remote Specialty Clearance & Authorization Specialist

Soleo Health Inc; United States; Remote; USD 42,000 - 62,000; 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 Clearance Specialist to process referrals, verify patient eligibility, adjudicate test claims, coordinate benefits, and estimate patient out-of-pocket costs. The role supports payer authorizations, prepares submissions, and follows up on approvals, working remotely in the USA.

Ideal candidates have at least 2 years of home infusion specialty pharmacy intake experience, knowledge of Medicare/Medicaid, and familiarity with payor contracts; strong Excel/Word skills and

Qualifications

• At least 2 years of home infusion specialty pharmacy intake experience.
• Experience with prior authorizations, benefit verification, and test claim adjudication.
• Knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.
• Strong Excel and Word skills; HIPAA familiarity.
• CPR+ experience preferred.

Responsibilities

• Verify patient insurance coverage and document coinsurance, copays, and deductibles.
• Calculate estimated patient financial responsibility from verifications and pricing.
• Initiate and follow up on prior authorizations and medical reviews.
• Prepare and submit payer authorization requests.
• Communicate with patients and referrals about status and updates.
• Refer patients to copay assistance programs as needed.
• Generate new patient start-of-care paperwork.
• Perform other duties as assigned.

Education

High school diploma or equivalent

Tools

CPR+

Excel

Word

Job description

Soleo Health is seeking a Clearance Specialist to process referrals, verify patient eligibility, adjudicate test claims, coordinate benefits, and estimate patient out-of-pocket costs. The role supports payer authorizations, prepares submissions, and follows up on approvals, working remotely in the USA.

Ideal candidates have at least 2 years of home infusion specialty pharmacy intake experience, knowledge of Medicare/Medicaid, and familiarity with payor contracts; strong Excel/Word skills and