Leap

Transparent pricing. Real savings. Better infusion care.

Care Operations Specialist

OperationsOperationsFull TimeRemoteTeam 11-50Since 2023Company SiteLinkedIn

Location

United States

Posted

4 days ago

Salary

$50K - $70K / year

Bachelor Degree2 yrs expEnglish

Job Description

• 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

Job 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

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