Insurance Verification Specialist

1 week ago

Houston, Texas, United States Soleo Health Inc Full time
Job Title: Insurance Verification Specialist

Soleo Health is seeking a highly skilled Insurance Verification Specialist to join our team. As a key member of our team, you will be responsible for verifying insurance benefits for specialty medications and services, as well as submitting and tracking authorization requests.

Responsibilities:
  • Verify insurance benefits for patients, including coverage of medications, administration supplies, and related infusion services
  • Document all information related to coinsurance, copay, deductibles, authorization requirements, etc.
  • Calculate estimated patient financial responsibility based on benefit verification and payer contracts
  • Initiate, follow-up, and secure prior authorization, pre-determination, or medical review, including reviewing and obtaining clinical documents for submission purposes
  • Communicate with patients, referral sources, other departments, and external customers regarding status of referral, coverage, and other updates as needed
  • Refer or assist patients who express financial necessity to manufacturer copay assistance programs and/or foundations
  • Generate new patient start of care paperwork
Requirements:
  • Home Infusion experience required
  • Experience with referrals, benefit verifications, and authorizations required
  • At least 2 years of home infusion pharmacy and/or medical intake/reimbursement experience preferred
  • High school diploma or equivalent
  • Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines, including ability to interpret payor contract fee schedules based on NDC and HCPCS units
  • Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met
  • Ability to work in a fast-paced environment
  • Knowledge of HIPAA regulations
  • Basic level skill in Microsoft Excel & Word
  • Knowledge of CPR+ preferred
About Us:

Soleo Health 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. Experience the Soleo Health Difference

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 is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: Prior Authorization coordinator, Insurance, Referrals, intake coordinator, healthcare eligibility, benefits verification coordinator, Patient Intake Coordinator, Patient care coordinator, medical receptionist, intake specialist

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