Remote Clearance Specialist

Job Summary

Working remotely full-time, the Clearance Specialist will process new referrals by verifying patient eligibility, coordinating benefits, and managing payer authorization requests while ensuring compliance with insurance guidelines.

Key responsibilities

• Perform benefit verification for patient insurance plans and document coverage details
• Calculate estimated patient financial responsibilities and secure prior authorizations
• Communicate with patients and referral sources regarding referral status and coverage updates

Required qualifications

• High school diploma or equivalent
• At least 2 years of experience in home infusion specialty pharmacy or medical intake/reimbursement
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines
• Basic proficiency in Microsoft Excel and Word
• Knowledge of HIPAA regulations