Insurance Clearance Specialist

Job Summary

To support a Specialty Infusion Pharmacy, the full-time Clearance Specialist will manage the processing of new referrals, including verifying patient eligibility, coordinating benefits, and securing prior authorizations, all while working remotely.

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 follow up on prior authorization requests while communicating 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 HIPAA regulations