Clearance Specialist (51)

Summary

To support a Specialty Infusion Pharmacy, the full-time Clearance Specialist will work remotely, processing new referrals, verifying patient eligibility, and managing payer authorization requests while adhering to a schedule of Thursday to Monday from 8:30 AM to 5:00 PM Mountain Time.Key responsibilities:Perform benefit verification of patient insurance plans and document coverage for medications and related servicesCalculate estimated patient financial responsibility based on benefit verification and payer contractsInitiate and secure prior authorizations and communicate with patients and referral sources regarding coverage updatesRequired qualifications:High school diploma or equivalentAt least 2 years of experience in home infusion specialty pharmacy or medical intake/reimbursement preferredWorking knowledge of Medicare, Medicaid, and managed care reimbursement guidelinesBasic proficiency in Microsoft Excel and WordKnowledge of HIPAA regulations and CPR+ preferred

Job Description

To support a Specialty Infusion Pharmacy, the full-time Clearance Specialist will work remotely, processing new referrals, verifying patient eligibility, and managing payer authorization requests while adhering to a schedule of Thursday to Monday from 8:30 AM to 5:00 PM Mountain Time.Key responsibilities:Perform benefit verification of patient insurance plans and document coverage for medications and related servicesCalculate estimated patient financial responsibility based on benefit verification and payer contractsInitiate and secure prior authorizations and communicate with patients and referral sources regarding coverage updatesRequired qualifications:High school diploma or equivalentAt least 2 years of experience in home infusion specialty pharmacy or medical intake/reimbursement preferredWorking knowledge of Medicare, Medicaid, and managed care reimbursement guidelinesBasic proficiency in Microsoft Excel and WordKnowledge of HIPAA regulations and CPR+ preferred