Acute Clearance Specialist

Job Summary

Working remotely, the full-time Acute Clearance Specialist will manage new referral processes, including verifying patient eligibility, coordinating benefits, and securing payer authorization requests for a Specialty Infusion Pharmacy.

Key responsibilities:

• Perform benefit verification for patient insurance plans and document coverage details
• Calculate estimated patient financial responsibilities based on benefit verification and payer contracts
• Initiate and follow up on prior authorization requests, including 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 and Word
• Knowledge of HIPAA regulations