Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!
Must have at least 2 years of home infusion specialty pharmacy experience, including prior authorizations, running test claims, and HCPC calculations. Hours are Monday-Friday 9:30am - 6pm Central Standard Time.
Soleo Health Perks:
- Competitive Wages
- 401(k) with a Match
- Referral Bonus
- Paid Time Off
- Great Company Culture
- Annual Merit Based Increases
- No Weekends or Holidays
- Paid Parental Leave Options
- Affordable Medical, Dental, & Vision Insurance Plans
- Company Paid Disability & Basic Life Insurance
- HSA & FSA (including dependent care) Options
- Education Assistance Program
The Position:
The Prior Authorization Coordinator ensures seamless patient care by maintaining prior authorizations, copay assistance, and verifying existing insurance coverage for ongoing services. Responsibilities include:
- Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits
- Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims
- Generates a prior authorization expiration report weekly, bi-weekly, or monthly
- Review clinical documents for prior authorization/pre-determination submission purposes
- Secures prior authorization, pre-determination, or medical review
- Contact prescriber’s office to obtain information that is required to complete ongoing re-authorization and verification of benefits
- Places outbound calls to patients or prescriber’s offices to notify of any delays due to more information needed to process or due to a prior authorization
- Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits
- Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner
- Ensures the appropriate notification of patients in regards to their financial responsibility, benefit coverage, and payor authorization for services to be provided
- Generates patient forms
- Maintains up to date prior authorization report
Schedule:
- Monday-Friday 9:30am - 6:00pm Central Standard Time
