Supporting the Specialty Infusion Pharmacy, the full-time Acute Clearance Specialist will process new referrals, verify patient eligibility, and manage payer authorization requests while working remotely during standard business hours.Key responsibilitiesPerform benefit verification for patient insurance plans and document coverage detailsCalculate estimated patient financial responsibility based on benefit verification and payer contractsInitiate and secure prior authorization, including reviewing and obtaining necessary clinical documentsRequired qualificationsHigh school diploma or equivalentAt least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferredWorking knowledge of Medicare, Medicaid, and managed care reimbursement guidelinesBasic level skill in Microsoft Excel & WordKnowledge of HIPAA regulations
Supporting the Specialty Infusion Pharmacy, the full-time Acute Clearance Specialist will process new referrals, verify patient eligibility, and manage payer authorization requests while working remotely during standard business hours.Key responsibilitiesPerform benefit verification for patient insurance plans and document coverage detailsCalculate estimated patient financial responsibility based on benefit verification and payer contractsInitiate and secure prior authorization, including reviewing and obtaining necessary clinical documentsRequired qualificationsHigh school diploma or equivalentAt least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferredWorking knowledge of Medicare, Medicaid, and managed care reimbursement guidelinesBasic level skill in Microsoft Excel & WordKnowledge of HIPAA regulations
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