Infusion Benefit Clearance Specialist

Job Summary

Supporting a Specialty Infusion Pharmacy, the full-time Infusion Benefit Clearance Specialist will manage patient referrals by verifying insurance eligibility, coordinating benefits, and securing prior authorizations, all while working remotely.

Key responsibilities

• Perform benefit verification for patient insurance plans, documenting coverage for medications and infusion services
• Calculate estimated patient financial responsibility based on benefit verification and payer contracts
• Initiate and secure prior authorizations, communicating with patients and referral sources regarding referral status and coverage updates

Required qualifications

• Infusion benefit verification and prior authorization experience required
• High school diploma or equivalent
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines
• Basic level skill in Microsoft Excel and Word
• Knowledge of HIPAA regulations