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Clearance Team Lead

Role overview

Qualifications

  • Specialty home infusion benefit verification and prior authorization experience required
  • At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
  • High School Diploma or equivalent
  • Intermediate level skills in Microsoft Excel

Responsibilities

  • Provide guidance to the team on referral processing standards, Soleo contracts, fee schedules, and therapy guidelines
  • Oversee the clearance team’s workload and direct the work of other staff members
  • Handle escalations and provide exceptional customer service to external and internal customers
  • Generate, update and distribute patient access-related reports as needed

Key facts

  • Remote from: Anywhere
  • Full time
  • Senior (5-10 years)
  • English

Other skills

  • Customer Service
  • Leadership
  • Microsoft Excel
  • Complex Problem Solving
  • Teamwork
  • Training And Development

About the company

Soleo Health logo

Soleo Health

Specialty Pharmacy

Frisco, Texas-based Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Soleo Health’s interdisciplinary team, comprised of experienced clinical pharmacists and registered nurses, utilizes a consistent patient management process, which leads to quantifiable clinical and economic value while improving patients’ experience. Soleo Health operates 20 locations throughout the U.S. with national nursing coverage and pharmacy licensure in 50 states, and is accredited by The Joint Commission. For more information, visit www.soleohealth.com.

Company details

Company typeXLarge
IndustrySpecialty Pharmacy
Company size501 - 1000

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Job description

Job Type
Full-time
Description

Soleo Health is seeking a Clearance Team Lead to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!   


Specialty home infusion benefit verification and prior authorization experience required.

 

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 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:

  • M-F 9:00am to 5:30pm Eastern 
Requirements
  • Specialty home infusion benefit verification and prior authorization experience required 
  • At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
  • High School Diploma or equivalent
  • Ability to interpret payor contract fee schedules based on NDC and HCPCS units 
  • Ability to effectively handle multiple priorities within a changing environment
  • Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems
  • Experience collaborating with internal resources to develop strategies that meet department goals within budget and established timelines
  • Intermediate level skills in Microsoft Excel 



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.


Keywords: Prior Auth, Insurance, Referrals, Home Infusion Prior Authorization, Home Infusion Benefits verification, Insurance Verification Specialist, Specialty Infusion Benefits Verification, Now Hiring, Hiring Now, Hiring Immediately, Immediately Hiring, clearance, patient access supervisor, intake manager, referral coordinator, referral manager, Patient Registration Manager, Prior Authorization Manager, Patient Intake Supervisor

Salary Description
$29-$33 per hour

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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