Acute Clearance Specialist – Intake Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage new referrals, which involves verifying patient eligibility, adjudicating test claims, coordinating benefits, and estimating out-of-pocket expenses.

• Conduct benefit verification for patient insurance plans, ensuring documentation of medication coverage, administration supplies, and associated infusion services.

• Record details regarding coinsurance, copays, deductibles, authorization requirements, and any pertinent information.

• Calculate the estimated financial responsibility of patients based on benefit verification, payer contracts, or the company’s self-pay pricing.

• Initiate, follow up, and secure prior authorizations, pre-determinations, or medical reviews.

• Review and gather clinical documents for submission.

• Communicate with patients, referral sources, departments, and both internal and external customers about the status of referrals and updates on coverage.

• Refer or assist patients in enrolling in manufacturer copay assistance programs and foundations.

• Generate the necessary start-of-care paperwork for new patients.

⛳️ Requirements

• Experience in acute home infusion is required.

• Must be available to work Full Time, from 8:30 am to 5:00 pm Central, plus on-call duties every 3-4 weeks.

• A high school diploma or equivalent is necessary.

• A minimum of 2 years in home infusion specialty pharmacy and/or medical intake/reimbursement experience is preferred.

• Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines is essential.

• Ability to interpret payer contract fee schedules based on NDC and HCPCS units is required.

• Strong multitasking skills to manage multiple referrals and priorities while meeting productivity expectations and quality standards.

• Capability to thrive in a fast-paced work environment.

• Knowledge of HIPAA regulations is a must.

• Basic proficiency in Microsoft Excel and Word is required.

• Familiarity with CPR+ is preferred.

🏝️ Benefits

• Competitive wages.

• 401(k) plan with a match.

• Referral bonus program.

• Paid time off.

• Positive company culture.

• Annual merit-based increases.

• No weekend or holiday shifts.

• Options for paid parental leave.

• Affordable medical, dental, and vision insurance plans.

• Company-paid disability and basic life insurance.

• Options for Health Savings Account (HSA) and Flexible Spending Account (FSA), including dependent care.

• Education assistance program.