Care Operations Specialist
Leap
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $50,000 - $70,000 per year
About the role
- Track and manage prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners
- Prepare and submit prior authorization documentation and monitor approval status
- Verify member eligibility and benefits to confirm coverage requirements for care initiation
- Maintain accurate records of authorization and eligibility status within Leap’s CRM/EHR systems
- Contact provider offices to obtain updated orders and clarify documentation requirements
- Track outstanding provider requests and follow up proactively to prevent delays in care
- Coordinate communication between provider offices, specialty pharmacies, and Leap’s clinical team
- Upload, organize, and maintain member records and clinical documentation accurately and in a timely manner
- Process incoming referrals, faxes, and documentation and route materials to the appropriate care team members
- Ensure documentation meets internal standards and HIPAA compliance requirements
- Answer inbound calls from providers, pharmacy partners, and occasionally members and route inquiries appropriately
- Document call details and ensure timely follow-through on related action items
- Represent Leap with professionalism and a service-oriented approach during all interactions
Requirements
- 2+ years of experience in a healthcare administrative or operations role supporting prior authorization or eligibility verification processes
- Familiarity with payer portals, prior authorization documentation workflows, and follow-up or appeal processes
- Proficiency with CRM or EHR systems and document management platforms including fax
- Proven ability to manage high volumes of administrative tasks with accuracy and attention to detail
- Comfortable coordinating across provider offices, payers, pharmacy partners, and internal clinical teams
- Strong organizational and communication skills in a fast-paced operational environment
- Ability to work independently during CST business hours in a fully remote setting.
- Clinical certification or licensure (CMA, RMA, CPhT, LPN, or similar) - Preferred
- Experience in a healthcare startup or high-growth environment - Preferred
- Experience in specialty infusion, home infusion, or rare disease programs - Preferred
- Spanish language fluency (spoken and written) - Preferred
Benefits
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Professional development opportunities
- Stock options
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
prior authorizationeligibility verificationdocumentation workflowsadministrative tasksattention to detailclinical documentationfax processingmember record managementHIPAA compliance
Soft Skills
organizational skillscommunication skillsservice-oriented approachindependenceproactive follow-up
Certifications
CMARMACPhTLPN