Insurance Clearance Specialist

Job Summary

Supporting the Specialty Infusion Pharmacy, the full-time remote Insurance Clearance Specialist will process new referrals, verify patient eligibility, and manage prior authorization requests while working from 9 am to 5:30 pm Eastern Time.

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 and communicate updates to patients and referral sources

Required qualifications

• At least 2 years of home infusion specialty pharmacy intake experience
• 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 CPR+ preferred