Care Operations Associate

🕒 vor 1 Monat

🇺🇸 Vereinigte Staaten – Remote

💵 $51.000 - $63.000 / Jahr

⏰ Vollzeit

🟢 Junior

🟡 Mittelstufe

⚙️ Operations

🦅 H1B-Visum-Sponsor

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👻 Geisterscore 19%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

Jetzt Bewerben
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Logo of Leap

Leap

11 - 50 Mitarbeiter

Gegründet 2023

🛡️ Versicherung

💼 Beratung

🏥 Gesundheitswesen

💰 €1.000.000 Venture Round - LEAP HEALTH im 2024-03

Insurance • Consulting • Healthcare

Leap ist die einzige transparente Spezialinfusions-Lösung für Arbeitgeber. Sie eliminiert versteckte Medikamentenaufschläge und bietet durchgehende Koordination der Spezialinfusionspflege - von der Apothekenbeschaffung bis zur Pflege zu Hause - um die Kosten für Spezialmedikamente zu senken und die Patientenerfahrung zu vereinfachen. Leap bedient selbstfinanzierte Arbeitgeber, Makler/Berater und Patienten mit einem technologiegestützten Pflegemodell, das die Infusionsausgaben senkt, das Engagement verbessert und jährliche Einsparungen bringt.

Beschreibung

• Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins • Keep eligibility status accurate and current for every active member in our systems • Manage medical prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners end to end • Prepare and submit PA documentation, track approval status, and escalate stalled or denied authorizations before they delay care • Chase down unsigned documents and orders—following up proactively with provider offices so nothing stalls in limbo • Process incoming referrals, faxes, and clinical documents, routing each to the right place • Coordinate clinical staffing with staffing agencies to ensure providers are in place for each member's treatment • Coordinate medication shipping with pharmacy partners so the right therapy arrives at the right time • Answer inbound calls from providers, pharmacy partners, and occasionally members, triaging and routing each inquiry to the right team member • Document call details accurately and follow through on any action items • Collect, organize, and store member records and clinical documentation accurately and on time • Ensure all files meet internal standards and HIPAA compliance requirements • Design, document, and continuously improve the workflows behind all of the above—turning manual, ad hoc tasks into repeatable systems as we scale

🎯 Anforderungen

• 2+ years in a healthcare administrative or operations role supporting prior authorization or eligibility verification • Familiarity with payer portals, PA workflows, and follow-up/appeal processes • Proficiency with CRM or EHR systems and document management platforms, including fax • A proven track record managing high volumes of detailed work without dropping the ball • Comfort coordinating across provider offices, payers, pharmacy partners, staffing agencies, and internal teams • Strong organizational and communication skills, and the ability to work independently during CST business hours in a fully remote setting

🏖️ Vorteile

• Competitive salary • Fully remote • Competitive health, dental, and vision coverage • 401(k) retirement plan • A rare chance to build operational infrastructure from the ground up at a fast-growing company where your work directly gets patients into treatment

Jetzt Bewerben

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