• Ensure seamless patient care by maintaining prior authorizations, copay assistance, and verifying insurance coverage for ongoing services. • Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims. • Generate prior authorization expiration report weekly, bi-weekly, or monthly. • Review clinical documents for prior authorization/pre-determination submission. • Secure prior authorization, pre-determination, or medical review. • Contact prescriber’s office for required information for ongoing re-authorization and verification of benefits. • Place outbound calls to patients or prescriber’s offices to notify of any delays due to more information needed to process or due to a prior authorization. • Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits. • Provide exceptional customer service to external and internal customers, resolving any customer requests in a timely manner. • Ensure appropriate notification of patients regarding their financial responsibility, benefit coverage, and payor authorization for services to be provided. • Generate patient forms. • Maintain up to date prior authorization report.

• Ensure seamless patient care by maintaining prior authorizations, copay assistance, and verifying existing insurance coverage for ongoing services • Must have a solid working knowledge of insurance plans and benefit structures to obtain detailed benefit information and maximize plan benefits • Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims • Generates a prior authorization expiration report weekly, bi-weekly, or monthly • Review clinical documents for prior authorization/pre-determination submission purposes • Secures prior authorization, pre-determination, or medical review • Contact prescriber’s office to obtain information that is required to complete ongoing re-authorization and verification of benefits • Places outbound calls to patients or prescriber’s offices to notify of any delays due to more information needed to process or due to a prior authorization • Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits • Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner • Ensures the appropriate notification of patients regarding their financial responsibility, benefit coverage, and payor authorization for services to be provided • Generates patient forms • Maintains up-to-date prior authorization report • Other duties as assigned

• Responsible for processing new referrals including but not limited to verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out of pocket costs • Perform benefit verification of all patient insurance plans including documenting coverage of medications, administration supplies, and related infusion services • Responsible to document all information related to coinsurance, copay, deductibles, authorization requirements, etc • Calculate estimated patient financial responsibility based off benefit verification and payer contracts and/or company self-pay pricing • Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including reviewing and obtaining clinical documents for submission purposes • Communicate with patients, referral sources, other departments, and any other external and internal customers regarding status of referral, coverage and/or other updates as needed • Refer or assist with enrollment of any patients who express financial necessity to manufacturer copay assistance programs and/or foundations • Generate new patient start of care paperwork

• Educate and assist patients with enrollment in copay and foundation assistance programs. • Prepare and send enrollment forms and related correspondence for patient assistance programs. • Stay current on federal, state, and contractual guidelines related to copay assistance. • Collaborate with cross-functional teams to ensure accurate and timely benefit navigation including providing support to Patient Ambassadors on complex benefit cases. • Create, explain, and verify ABNs to ensure accuracy and protect revenue. • Assist patients experiencing financial hardship through the internal Soleo Assistance Program. • Manage renewals for all manufacturers, foundation, and Soleo Assistance Program (SAP) cases. • Ensure compliance with manufacturer program requirements, including report creation and maintenance. • Support supervisors and managers with special projects assigned.