Infusion Benefit Coordinator – Clearance Specialist

🕒 Julho 31

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Soleo Health

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2013

🏥 Saúde

⚕️ Seguro de Saúde

💊 Farmacêutico

Healthcare • Healthcare Insurance • Pharmaceuticals

A Soleo Health é uma empresa de farmácia especializada que vai além do simples preenchimento de prescrições, proporcionando experiências personalizadas para pacientes e acesso a medicamentos especializados e terapias de infusão. Eles oferecem tratamento na casa dos pacientes, nos consultórios dos provedores ou em um dos muitos centros de infusão em todo o país. A Soleo Health é especializada no tratamento de doenças complexas e ultrarraras com foco na melhoria da qualidade de vida dos pacientes e na otimização dos resultados de saúde. Trabalham em estreita colaboração com pacientes, provedores, fabricantes farmacêuticos, pagadores e sistemas de saúde para fornecer terapias de alto custo, demonstrando valor através de dados de resultados no mundo real. A Soleo Health é reconhecida por sua excelência clínica e dedicação ao cuidado do paciente, e oferece serviços em todo o país, incluindo um portal online, Soleo Connect®, para comunicação em tempo real.

Descrição

• 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 • Generate new patient start of care paperwork • Other duties as assigned

🎯 Requisitos

• Infusion benefit verification and prior authorization experience required • Experience running test claims and calculating HCPC codes required • High school diploma or equivalent • 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 • Ability to work in a fast-paced environment • Knowledge of HIPAA regulations • Basic level skill in Microsoft Excel & Word • Knowledge of CPR+ preferred

🏖️ Benefícios

• Competitive Wages • 401(k) with a 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