The Clearance Team Lead provides daily support and guidance to the Patient Access team, assists with escalations, participates in complex therapy benefit verification and prior authorization submissions, and performs duties of both the Clearance Specialist and Prior Authorization Coordinator. They work closely with the Patient Access Supervisor to ensure the team meets or exceeds productivity and quality expectations while delivering exceptional patient care. Responsibilities include:
Acts as a resource for colleagues: Provide guidance to the team on referral processing standards, Soleo contracts, fee schedules, therapy guidelines, and supported therapies
Monitor and assign referral workload: Oversee the clearance team's workload and direct the work of other staff members
Serve as a Subject Matter Expert: Works autonomously to handle more complex issues related to benefits and authorization within established procedures and practices
Handle escalations: Provide exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner
Assist in training new team members: Ensure new team members understand their roles and responsibilities and provide ongoing training to enhance their skills and knowledge
Support Patient Access team members: Provide necessary guidance, feedback and counseling and may contribute input for performance evaluations
Generate and update reports: Create, update and distribute patient access-related reports as needed
Perform duties of a Clearance Specialist and Prior Authorization Coordinator
Schedule:
Monday-Friday 8:30-5p
Must have experience with Specialty Infusion for Prior authorization/Benefits Verification
Prefer someone with training or lead experience
Requirements
At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred
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
High school diploma or equivalent
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.
Salary Description
$26.50-$30 per hour
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