Remote Life Insurance Professional

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

Referral Bonus

• No Weekends or Holidays
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• 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. 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
Must be able to work Full time, 40 hours per week, Monday-Friday
~Must have experience with Acute Infusion for Prior authorization/Benefits Verification

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
Basic level skill in Microsoft Excel & Word
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. Encourage unlimited ideas and creative thinking
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. 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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