Clearance Team Lead

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Soleo Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🧘 Wellness

Healthcare Insurance • Pharmaceuticals • Wellness

Soleo Health is a specialty pharmacy company that goes beyond simply filling prescriptions by providing personalized patient experiences and access to specialized medications and infusion therapies. They offer treatment in patients' homes, in providers' offices, or at one of their many nationwide infusion centers. Soleo Health specializes in treating complex and ultra-rare diseases with a focus on improving patient quality of life and optimizing health outcomes. They work closely with patients, providers, pharmaceutical manufacturers, payors, and health systems to deliver high-cost therapies, demonstrating value through real-world outcome data. Soleo Health is recognized for its clinical excellence and dedication to patient care, and offers nationwide services, including an online portal, Soleo Connect®, for real-time communication.

📋 Description

• Provide daily support and guidance to the Patient Access team • Assist with escalations • Participate in complex therapy benefit verification and prior authorization submissions • Perform duties of both the Clearance Specialist and Prior Authorization Coordinator • Oversee the clearance team’s workload and direct the work of other staff members • Work autonomously to handle more complex issues related to benefits and authorization within established procedures and practices • Provide exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner • Ensure new team members understand their roles and responsibilities and provide ongoing training to enhance their skills and knowledge • Provide necessary guidance, feedback and counseling and may contribute input for performance evaluations • Create, update and distribute patient access-related reports as needed

🎯 Requirements

• Specialty home infusion benefit verification and prior authorization experience required • At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines • High School Diploma or equivalent • Ability to interpret payor contract fee schedules based on NDC and HCPCS units • Ability to effectively handle multiple priorities within a changing environment • Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems • Experience collaborating with internal resources to develop strategies that meet department goals within budget and established timelines • Intermediate level skills in Microsoft Excel

🏖️ Benefits

• 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