Specialty Pharmacy Intake Coordinator

7 days ago


Dublin, Ohio, United States Soleo Health Inc Full time
Job Description

Job Summary:

Soleo Health Inc is seeking a highly skilled Insurance Clearance Specialist to join our team. As a key member of our specialty pharmacy team, you will be responsible for processing new referrals, verifying patient eligibility, and coordinating benefits.

Key Responsibilities:

  • Referral Processing: Verify patient eligibility, test claim adjudication, and coordination of benefits to ensure seamless patient care.
  • Payer Authorization: Prepare, submit, and follow up on payer authorization requests to secure prior authorization, pre-determination, or medical review.
  • Financial Responsibility: Calculate estimated patient financial responsibility based on benefit verification and payer contracts.
  • Communication: Communicate with patients, referral sources, and other departments regarding referral status, coverage, and updates.
  • Enrollment Assistance: Refer or assist patients with enrollment in manufacturer copay assistance programs and/or foundations.
  • Administrative Tasks: Generate new patient start of care paperwork and perform other duties as assigned.

Requirements:

  • Education: High school diploma or equivalent.
  • Experience: At least 2 years of home infusion specialty pharmacy experience required.
  • Knowledge: Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines, including ability to interpret payor contract fee schedules.
  • Skills: Strong ability to multi-task, support numerous referrals/priorities, and ensure productivity expectations and quality are met.
  • Knowledge: Basic level skill in Microsoft Excel & Word.
  • Knowledge: Knowledge of HIPAA regulations.

About Us:

Soleo Health Inc is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset.

Soleo's Core Values:

  • Improve patients' lives every day.
  • Be passionate in everything you do.
  • Encourage unlimited ideas and creative thinking.
  • Make decisions as if you own the company.
  • Do the right thing.
  • Have fun.

Soleo Health Inc is committed to diversity, equity, and inclusion.



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