Specialty Clearance Specialist

Job Summary

Working remotely, the full-time Specialty Clearance Specialist will manage new referrals by verifying patient eligibility, processing prior authorizations, and calculating estimated patient out-of-pocket costs for a Specialty Infusion Pharmacy.

Key responsibilities

• Perform benefit verification for patient insurance plans and document coverage details
• 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

• 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