Clearance Team Lead

Job Description

Job Description

Description:

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

Specialty home infusion benefit verification and prior authorization experience required.

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

The Position:

The Clearance Team Lead provides daily support and guidance to the Patient Access team, assists with escalations, participates in complex therapy benefit verification and prior authorization submissions, and performs duties of both the Clearance Specialist and Prior Authorization Coordinator. They work closely with the Patient Access Supervisor to ensure the team meets or exceeds productivity and quality expectations while delivering exceptional patient care. Responsibilities include:

• Acts as a resource for colleagues: Provide guidance to the team on referral processing standards, Soleo contracts, fee schedules, therapy guidelines, and supported therapies.
• Monitor and assign referral workload: Oversee the clearance team’s workload and direct the work of other staff members.
• Serve as a Subject Matter Expert: Works autonomously to handle more complex issues related to benefits and authorization within established procedures and practices.
• Handle escalations: Provide exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner.
• Assist in training new team members: Ensure new team members understand their roles and responsibilities and provide ongoing training to enhance their skills and knowledge.
• Support Patient Access team members: Provide necessary guidance, feedback and counseling and may contribute input for performance evaluations.
• Generate and update reports: Create, update and distribute patient access-related reports as needed
• Perform duties of a Clearance Specialist and Prior Authorization Coordinator.

Schedule:

• M-F 9:00am to 5:30pm Eastern

• Specialty home infusion benefit verification and prior authorization experience required
• At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
• High School Diploma or equivalent
• Ability to interpret payor contract fee schedules based on NDC and HCPCS units
• Ability to effectively handle multiple priorities within a changing environment
• Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems
• Experience collaborating with internal resources to develop strategies that meet department goals within budget and established timelines
• Intermediate level skills in Microsoft Excel

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.

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