Salary
💰 $60,000 - $75,000 per year
About the role
- Maintain relationships with assigned payer organization personnel in a customer service capacity
- Support Soleo Health’s contracted clients as assigned
- Communicate effectively with payers via email, phone, letter, or portal
- Collaborate with the assigned Payor Director or Senior Director
- Serve as Manager between payers and Soleo departments
- Manage daily communications with designated health plans
- Handle direct referral processes and respond to case managers within required timeframes
- Follow up on payer initiatives and program requirements
- Use Soleo software to review account notes and pricing
- Send updated logs as required by payers
- Act as primary contact for assigned payer initiatives
- Support contract implementation and ensure compliance
- Prepare and submit client reports by due dates
- Complete ad hoc reports and projects as requested
- Assist with reimbursement projects and address client billing inquiries
- Adhere to Soleo Health policies, procedures, and standards of conduct
- Attend mandatory annual training courses
- Report known or suspected violations of policies or standards
- Perform other related duties as assigned
Requirements
- Home infusion and/or specialty pharmacy required
- Bachelor’s degree in business administration, Healthcare Administration, or a related field (preferred), or equivalent relevant experience
- 2–4 years of experience in healthcare, managed care, customer service, or client account management
- Experience with payor relationships and working within healthcare contracts, credentialing, and re-credentialing processes
- Familiarity with case management procedures, referral processes, and billing/reimbursement systems
- Experience using healthcare management software and online portals for payor and referral management
- Must have organizational, written, communication and interpersonal skills
- Proficient in Microsoft Office and other applications including Word, and Excel