Acute Clearance Specialist

Job Summary

Working remotely on a full-time basis, the Acute Clearance Specialist will manage the insurance intake process by verifying patient eligibility, processing prior authorizations, and calculating estimated patient financial responsibilities for a specialty infusion pharmacy.

Key responsibilities

• Perform benefit verification for patient insurance plans, documenting coverage for medications and related services
• Initiate and secure prior authorizations, including reviewing and obtaining necessary clinical documents
• Communicate with patients and referral sources regarding the status of referrals and coverage updates

Required qualifications

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