Soleo Health Inc

The Prior Authorization Coordinator is responsible for ensuring seamless patient care by maintaining prior authorizations, copay assistance, and verifying existing insurance coverage for ongoing services. Key duties involve generating reports, reviewing clinical documents, securing authorizations, and communicating with prescribers' offices and patients regarding status and financial responsibility.

The Clearance Specialist is responsible for processing new referrals, which includes verifying patient eligibility, testing claim adjudication, coordinating benefits, and calculating estimated patient out-of-pocket costs. They must also prepare, submit, and follow up on payer authorization requests.

This role is responsible for designing, implementing, and maintaining comprehensive training programs to ensure pharmacy and operational teams effectively use critical technology platforms supporting specialty pharmacy operations. Key duties include partnering with cross-functional teams to create training strategies for deployments, developing end-user materials, leading implementation training, and ensuring staff competency in regulated environments.

The Billing Specialist is primarily responsible for insurance and self-pay billing, excluding Medicare, which involves submitting electronic and paper claims and following up on rejections with clearing house vendors. Responsibilities also include preparing accurate medical claims based on contracted agreements, reviewing pricing discrepancies, creating and submitting secondary claims, and billing manufacturer copays.