Insurance Clearance Specialist

Job Summary

Supporting a Specialty Infusion Pharmacy, the full-time Clearance Specialist will process new referrals, verify patient eligibility, and manage prior authorization requests while working remotely in the USA.

Key responsibilities

• Perform benefit verification and document coverage details for patient insurance plans
• Calculate estimated patient financial responsibility based on benefit verification and payer contracts
• Initiate and secure prior authorization, including reviewing and obtaining necessary clinical documents

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 proficiency in Microsoft Excel and Word
• Knowledge of HIPAA regulations