Soleo Health · 6 hours ago

Clearance Team Lead

Norcross, GA

Full-time

Remote

Senior Level

$25/hr - $29/hr

2+ years exp

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Responsibilities

Monitors and assigns referral workload to clearance team

Generates referral reports weekly, bi-weekly, or monthly and distributes among staff with KPIs

Trains and retrains clearance specialists

Maintains ongoing log of referrals received and completed

Counsels clearance specialists as necessary

Intervenes or escalates referrals not processed within required timeframe

Facilitates new referral project coordination with internal customers (RBLs, Ops Managers)

Provides guidance to team regarding referral processing standards, Soleo contracts, fee schedules, therapy guidelines and supported therapies

Must have a solid working knowledge of insurance plans and benefit structures

In cases of escalation, places outbound calls to internal or external customers as requested to notify of delays due to benefit verification

Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner

Qualification

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Medical benefit experiencePharmacy benefit experienceSpecialty pharmacy experienceHome infusion pharmacy experienceReimbursement experienceMedicare knowledgeMedicaid knowledgeManaged Care knowledgePayor contract interpretationMicrosoft ExcelMicrosoft Word