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Specialty Clearance Specialist - Intake Coordinator - Remote

$23 - $27 per hour

Soleo Health

Frisco, TX
  • Remote job

Job Title Clearance Specialist – Full‑time, Remote (USA) Overview Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy. Join us in simplifying complex care! Acute home infusion experience required. Must be able to work 9 am‑5:30 pm Central Time, and on‑call once every 4 weeks. Key Responsibilities Process new referrals, verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out‑of‑pocket costs. Prepare, submit, and follow up on payer authorization requests. Perform benefit verification of all patient insurance plans, documenting coverage of medications, administration supplies, and related infusion services. Document all information related to coinsurance, copay, deductibles, authorization requirements, and other financial details. Calculate estimated patient financial responsibility based on benefit verification and payer contracts 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. Communicate with patients, referral sources, other departments, and external and internal customers regarding status of referral, coverage, and updates as needed. Refer or assist patients who express financial necessity to manufacturer copay assistance programs and/or foundations. Generate new patient start‑of‑care paperwork. Schedule Full time, 40 hours per week, Monday‑Friday. 9 a‑5:30 p Central Time (with a 30‑min lunch). Weekend on‑call once every 4 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 payer contract fee schedules based on NDC and HCPCS units. Strong ability to multi‑task while supporting numerous referrals/priorities and meeting productivity and quality expectations. Ability to work in a fast‑paced environment. Knowledge of HIPAA regulations. Basic skill in Microsoft Excel & Word. Knowledge of CPR+ preferred. Benefits Competitive wages. 401(k) with 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. 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! EEO Statement 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 an equal opportunity to thrive. 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. Salary $23.00 – $27.00 per hour 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 #J-18808-Ljbffr Soleo Health

Vacancy posted 4 days ago
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