To support a Specialty Infusion Pharmacy, the full-time Clearance Specialist will manage new referrals, verify patient eligibility, and secure prior authorizations while working remotely. Key responsibilities Perform benefit verification of patient insurance plans and document coverage details Calculate estimated patient financial responsibility based on benefit verification and payer contracts Initiate and follow up on prior authorization requests, ensuring all necessary clinical documents are submitted Required qualifications At least 2 years of home infusion specialty pharmacy experience, including prior authorizations and benefit verifications High school diploma or equivalent Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines Basic proficiency in Microsoft Excel and Word Knowledge of HIPAA regulations
Prior Authorization Specialist • Escondido, California, United States
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