Clearance Specialist - Insurance Intake Coordinator
Core
Supports intake and financial clearance for patients receiving complex specialty infusion services by verifying insurance benefits and processing claims.
Role type
Specialty pharmacy intake coordinator
Builds
Patient care pathways for complex infusion services
Domain
Healthcare / Specialty Pharmacy / Insurance Reimbursement
Deliverable
Dashboards & analysis
Required skills
Insurance benefit verification, test claim adjudication, coordination of benefits, prior authorization management, HCPCS/NDC calculations, payer contract interpretation, patient financial responsibility assessment
Preferred skills
CPR certification
Technologies
Microsoft Excel, Microsoft Word
Responsibilities
Process new patient referrals including insurance eligibility verification and test claim adjudication; Perform detailed benefit verification for medications and infusion services; Calculate estimated patient out-of-pocket responsibility; Initiate and secure prior authorizations and medical reviews; Review clinical documentation for payer submissions; Assist patients with manufacturer copay assistance programs; Generate new patient start-of-care documentation
Seniority
Mid-level, hands-on IC