Description

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

Acute home infusion experience required, and must be able to work 8.00-4:30pm Central Time.

Soleo Health Perks:

Competitive Wages
401(k) with a Match
Referral Bonus
Paid Time Off
Great Company Culture
Annual Merit Based Increases
No Weekends or Holidays
Paid Parental Leave Options
Affordable Medical, Dental, & Vision Insurance Plans
Company Paid Disability & Basic Life Insurance
HSA & FSA (including dependent care) Options
Education Assistance Program

This Position:

The Clearance Specialist is responsible for processing new referrals including but not limited to verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out of pocket costs. They will also be responsible for preparation, submission, and follow up of payer authorization requests. Responsibilities include:

Perform benefit verification of all patient insurance plans including documenting coverage of medications, administration supplies, and related infusion services
Responsible to document all information related to coinsurance, copay, deductibles, authorization requirements, etc
Calculate estimated patient financial responsibility based off benefit verification and payer contracts and/or company self-pay pricing
Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including
Reviewing and obtaining clinical documents for submission purposes
Communicate with patients, referral sources, other departments, and any other external and internal customers regarding status of referral, coverage and/or other updates as needed
Refer or assist with enrollment any patients who express financial necessity to manufacturer copay assistance programs and/or foundations
Generate new patient start of care paperwork

Schedule:

Must be able to work Full time, 40 hours per week, Monday-Friday
8.00-4:30pm Central Time (with a 30 min lunch)
Weekend on-call once every 3 weeks
Must have experience with Acute Infusion for Prior authorization/Benefits Verification

Requirements

High school diploma or equivalent
At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred
Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines including ability to interpret payor contract fee schedules based on NDC and HCPCS units
Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met
Ability to work in a fast-paced environment
Knowledge of HIPAA regulations
Basic level skill in Microsoft Excel & Word
Knowledge of CPR+ preferred

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

Soleo’s Core Values:

Improve patients’ lives every day
Be passionate in everything you do
Encourage unlimited ideas and creative thinking
Make decisions as if you own the company
Do the right thing
Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: Prior Auth, Insurance, Referrals, Home Infusion Prior Authorization, Home Infusion Benefits verification, Insurance Verification Specialist, Specialty Infusion Benefits Verification, Now Hiring, Hiring Now, Hiring Immediately, Immediately Hiring

Soleo Health Inc

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