Clearance Specialist (48)

Summary

To support a Specialty Infusion Pharmacy, the full-time Clearance Specialist will process new referrals, verify patient eligibility, and secure prior authorizations while working remotely.Key responsibilitiesPerform benefit verification of patient insurance plans and document coverage detailsCalculate estimated patient financial responsibility based on benefit verification and payer contractsInitiate and follow up on prior authorization requests, including obtaining necessary clinical documentsRequired qualificationsAt least 2 years of home infusion specialty pharmacy intake experienceHigh school diploma or equivalentWorking knowledge of Medicare, Medicaid, and managed care reimbursement guidelinesBasic level skills in Microsoft Excel and WordKnowledge of HIPAA regulations

Job Description

To support a Specialty Infusion Pharmacy, the full-time Clearance Specialist will process new referrals, verify patient eligibility, and secure prior authorizations while working remotely.Key responsibilitiesPerform benefit verification of patient insurance plans and document coverage detailsCalculate estimated patient financial responsibility based on benefit verification and payer contractsInitiate and follow up on prior authorization requests, including obtaining necessary clinical documentsRequired qualificationsAt least 2 years of home infusion specialty pharmacy intake experienceHigh school diploma or equivalentWorking knowledge of Medicare, Medicaid, and managed care reimbursement guidelinesBasic level skills in Microsoft Excel and WordKnowledge of HIPAA regulations