LEAP, a New York City based non-profit organization was founded in 1977 in an effort to improve public education and help students realize their full potential
Care Operations Associate
Location
United States
Posted
6 days ago
Salary
$51K - $63K / year
Seniority
Mid Level
Job Description
Care Operations Associate
LEAP
• Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins • Keep eligibility status accurate and current for every active member in our systems • Manage medical prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners end to end • Prepare and submit PA documentation, track approval status, and escalate stalled or denied authorizations before they delay care • Chase down unsigned documents and orders—following up proactively with provider offices so nothing stalls in limbo • Process incoming referrals, faxes, and clinical documents, routing each to the right place • Coordinate clinical staffing with staffing agencies to ensure providers are in place for each member's treatment • Coordinate medication shipping with pharmacy partners so the right therapy arrives at the right time • Answer inbound calls from providers, pharmacy partners, and occasionally members, triaging and routing each inquiry to the right team member • Document call details accurately and follow through on any action items • Collect, organize, and store member records and clinical documentation accurately and on time • Ensure all files meet internal standards and HIPAA compliance requirements • Design, document, and continuously improve the workflows behind all of the above—turning manual, ad hoc tasks into repeatable systems as we scale
Job 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
- A proven track record managing high volumes of detailed work without dropping the ball
- Comfort coordinating across provider offices, payers, pharmacy partners, staffing agencies, and internal teams
- Strong organizational and communication skills, and the ability to work independently during CST business hours in a fully remote setting
Benefits
- Competitive salary
- Fully remote
- Competitive health, dental, and vision coverage
- 401(k) retirement plan
- A rare chance to build operational infrastructure from the ground up at a fast-growing company where your work directly gets patients into treatment
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