Acute Clearance Specialist

Job Summary

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 responsibilities

• Perform benefit verification for patient insurance plans and document coverage details
• Calculate estimated patient financial responsibility based on benefit verification and payer contracts
• Initiate and secure prior authorization, including reviewing and obtaining necessary clinical documents

Required qualifications

• High school diploma or equivalent
• At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines
• Basic level skill in Microsoft Excel & Word
• Knowledge of HIPAA regulations