Prior Authorization Coordinator
Description
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!
Specialty infusion prior authorization experience required. Hours are Monday-Friday 9:00am - 5:30pm Eastern 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 9:00am-5:30pm Eastern Standard Time
Requirements
High school diploma or equivalent required.
At least 2 years of healthcare intake/admissions and/or reimbursement experience
Previous medical and pharmacy benefit experience is required
Initiating and securing prior authorizations, pre-determination, and appeals
Ability to interpret payor contract fee schedules based on NDC and HCPCS units
Ability to effectively handle multiple priorities within a changing environment
Basic level skill in Microsoft Excel
Basic level skill in Microsoft Word
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.
Apply To This Job
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!
Specialty infusion prior authorization experience required. Hours are Monday-Friday 9:00am - 5:30pm Eastern 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 9:00am-5:30pm Eastern Standard Time
Requirements
High school diploma or equivalent required.
At least 2 years of healthcare intake/admissions and/or reimbursement experience
Previous medical and pharmacy benefit experience is required
Initiating and securing prior authorizations, pre-determination, and appeals
Ability to interpret payor contract fee schedules based on NDC and HCPCS units
Ability to effectively handle multiple priorities within a changing environment
Basic level skill in Microsoft Excel
Basic level skill in Microsoft Word
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.
Apply To This Job