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Specialty Clearance Specialist - Benefits Verification Specialist

L5

soleo healthDenver, COyesterday

$23.00 - $27.00 per hour

Occupations

Medical Records SpecialistsPharmacistsPharmacy Technicians

Industries

All Other Miscellaneous Ambulatory Health Care ServicesAll Other Outpatient Care CentersPharmacies and Drug Retailers
Job TypeFull-time
Description: Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Must have at least 2 years of home infusion specialty pharmacy experience, including prior authorizations, benefit verifications, running test claims, and HCPC calculations. The hours are 8:30am to 5pm Central Time Zone. Soleo Health Perks:
  • Competitive Wages 401(k) with a Match
  • Referral BonusPaid Time OffGreat 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 InsuranceHSA & 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
  • Other duties as assigned
Schedule: Monday-Friday, 8:30am to 5pm Central Time Zone, Full-Time
Requirements:
  • At least 2 years of home infusion specialty pharmacy intake experience required
  • High school diploma or equivalent
  • 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 doEncourage 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, Now hiring, hiring now, immediately hiring, hiring immediately Salary Description$23-$27 per hour
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Level

SeniorL5

Salary

$23.00 - $27.00 per hour

Location

Denver, CO

Occupation

Medical Records Specialists

Industry

All Other Miscellaneous Ambulatory Health Care Services

Posted

yesterday

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