Clearance Team Lead

Job Summary

Providing daily support and guidance to the Patient Access team, the full-time remote Clearance Team Lead will assist with escalations, manage referral workloads, and participate in complex therapy benefit verification and prior authorization submissions.

Key responsibilities

• Act as a resource for colleagues by providing guidance on referral processing standards, contracts, and therapy guidelines
• Monitor and assign referral workload while overseeing the clearance team's productivity and quality expectations
• Serve as a Subject Matter Expert to handle complex issues related to benefits and authorization

Required qualifications

• Specialty home infusion benefit verification and prior authorization experience
• At least 2 years of experience with 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
• Intermediate level skills in Microsoft Excel