Remote Clearance Specialist

Job Summary

Working remotely full-time, the Clearance Specialist will manage new referrals by verifying patient eligibility, processing payer authorization requests, and calculating estimated patient financial responsibilities within a specialty infusion pharmacy environment.

Key responsibilities

• Perform benefit verification for patient insurance plans, documenting coverage and related infusion services
• Initiate and secure prior authorizations, including reviewing and obtaining necessary clinical documents
• 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 and CPR+ preferred