Care Operations Associate
New
L
LeapHealthcare / Pharmacy
US (Remote), CSTFull-TimeMiddle
Salary$51K - $63K
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Job Details
- Experience
- 2+ years
- Required Skills
- CRMEHR
Requirements
- 2+ years in a healthcare administrative or operations role supporting prior authorization or eligibility verification.
- Familiarity with payer portals, PA workflows, and follow-up/appeal processes.
- Proficiency with CRM or EHR systems and document management platforms, including fax.
- Proven track record managing high volumes of detailed work.
- Ability to coordinate across provider offices, payers, pharmacy partners, and staffing agencies.
- Strong organizational and communication skills.
- Ability to work independently during CST business hours.
- Clinical certification or licensure (e.g., CMA, RMA, CPhT, LPN) is a plus.
- Experience in a healthcare startup or high-growth environment is a plus.
- Experience in specialty or home infusion programs is a plus.
- Spanish fluency (spoken and written) is a plus.
Responsibilities
- Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins.
- Manage medical prior authorization requests, renewals, and extensions end to end.
- Prepare and submit PA documentation and escalate stalled or denied authorizations.
- Follow up with provider offices to secure unsigned documents and orders.
- Coordinate clinical staffing and medication shipping with partners.
- Answer and route inbound calls from providers, pharmacies, and members.
- Maintain accurate member records in compliance with HIPAA standards.
- Design and document repeatable workflows for administrative processes.
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