Specialty Clearance Specialist - Intake

📋 Description

• Process new patient referrals by verifying insurance eligibility, reviewing coverage, and
• Perform benefit verifications for medications, administration supplies, and related infusion
• Review and document copayments, coinsurance, deductibles, prior authorization requirements, and
• Run test claims and calculate estimated patient out-of-pocket expenses using insurance benefit
• Initiate, prepare, submit, and follow up on prior authorizations, predeterminations, and medical
• Review and obtain clinical documentation required for authorization submissions and reimbursement

🎯 Requirements

• High school diploma or equivalent.
• At least 2 years of experience in home infusion or specialty pharmacy intake, with hands-on
• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.
• Ability to interpret payer contract fee schedules using National Drug Codes (NDC) and Healthcare
• Experience reviewing insurance coverage, calculating patient financial responsibility, and managing
• Knowledge of HIPAA regulations and the importance of maintaining patient confidentiality.

🎁 Benefits

• Competitive hourly compensation of $23–$27 per hour.
• Fully remote work opportunity within the United States.
• 401(k) retirement plan with employer matching.
• Paid time off (PTO).
• No weekend or holiday shifts.
• Paid parental leave options.