Reimbursement Coordinator

222 Cardinal Health 110, LLC; United States; Remote; USD 32,000 - 41,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Health Savings Account

401k plan

MyFlexPay

FSAs

Disability coverage

Parental leave

Wellness programs

Job summary

Cardinal Health is seeking a remote, full-time Customer Service Associate for the Individualized Care program in the United States. You will be the first contact on inbound calls, enroll patients, verify documentation, and assist with benefit investigations to secure coverage.

Role requires 3–6 years of experience, Medicare/Medicaid knowledge, strong MS Office skills, and the ability to work in a high-volume environment. A comprehensive benefits package accompanies a competitive hourly pay range.

Qualifications

• 3–6 years of experience, preferred
• Patient Support Service experience preferred
• Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payer policies preferred
• Knowledge of Medical expenses and Medicare Administrative Contractor practices preferred
• Understanding of Medical, Supplemental, and pharmacy insurance benefit practices preferred
• 1–2 years experience with Prior Authorization and Appeal submissions preferred
• Able to work with high-volume production teams with emphasis on quality
• Proficient in Microsoft Office including Word, Outlook, and Excel preferred
• Previous medical experience is preferred
• Adaptable and flexible preferred
• Self-motivated and dependable preferred
• Strong problem solving ability preferred
• Bilingual preferred

Responsibilities

• First point of contact on inbound calls and determine needs
• Create and complete accurate enrollment applications with urgency
• Scrutinize forms and documentation for missing or new information
• Conduct outbound correspondence to support patient needs
• Resolve questions regarding status of assistance requests
• Maintain detailed notes for every interaction in the system
• Make outbound calls to discuss missing information or benefit details
• Assess patient’s financial ability to afford therapy and guide to assistance
• Provide detailed activity notes for Benefit Investigation processing
• Collaborate with teammates to support patient population
• Follow through on benefit investigation rejections including Prior Authorizations and Appeals
• Track payer/plot issues and report changes to management
• Explain various insurance programs to patients to select best coverage
• Handle escalations and ensure timely resolutions
• Research payer/physician/pharmacy issues to resolve swiftly

Skills

Patient support experience

Medicare/Medicaid knowledge

Microsoft Office

Communication skills

Bilingual (prefered)

Education

High School Diploma or GED

Tools

Microsoft Word

Outlook

Excel

Job description

What Individualized Care contributes to Cardinal Health

Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions—driving brand and patient markers of success. We’re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.

Together, we can get life-changing therapies to patients who need them—faster.

Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Individualized Care provides care that is planned to meet the particular needs of an individual patient.

Responsibilities

• First point of contact on inbound calls and determines needs and handles accordingly.
• Creates and completes accurate applications for enrollment with a sense of urgency.
• Scrutinizes forms and supporting documentation thoroughly for any missing information or new information to be added to the database.
• Conducts outbound correspondence when necessary to help support the needs of the patient and/or program.
• Resolve patient’s questions and any representative for the patient’s concerns regarding status of their request for assistance.
• Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry.
• Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information.
• Assess patient’s financial ability to afford therapy and provide hand on guidance to appropriate financial assistance.
• Provides detailed activity notes as to what appropriate action is needed for the Benefit Investigation processing.
• Working alongside teammates to best support the needs of the patient population .
• Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted.
• Track any payer/plan issues and report any changes, updates, or trends to management
• Search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation
• Handle all escalations based upon region and ensure proper communication of the resolution within required timeframe agreed upon by the client
• As needed conduct research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues swiftly

Qualifications

• 3-6 years of experience, preferred
• High School Diploma, GED, or equivalent work experience, preferred
• Patient Support Service experience, preferred
• Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payer policies and guidelines for coverage, preferred
• Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred
• Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred
• 1-2 years experience with Prior Authorization and Appeal submissions, preferred
• Ability to work with high volume production teams with an emphasis on quality
• Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and preferred Excel capabilities
• Previous medical experience is preferred
• Adaptable and Flexible, preferred
• Self-Motivated and Dependable, preferred
• Strong ability to problem solve, preferred
• Bilingual is preferred

What is expected of you and others at this level

• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
• In-depth knowledge in technical or specialty area
• Applies advanced skills to resolve complex problems independently
• May modify process to resolve situations
• Works independently within established procedures; may receive general guidance on new assignments
• May provide general guidance or technical assistance to less experienced team members

TRAINING AND WORK SCHEDULES:

Your new hire training will take place 8:00am-5:00pm CST, mandatory on camera attendance is required.

This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 8:00am- 5:00pm CST.

REMOTE DETAILS:

You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.

• Download speed of 15Mbps (megabyte per second)
• Upload speed of 5Mbps (megabyte per second)
• Ping Rate Maximum of 30ms (milliseconds)
• Hardwired to the router
• Surge protector with Network Line Protection for CAH issued equipment

Anticipated hourly range:

$23.10 per hour - $29.61 per hour

Bonus eligible:

No

Benefits:

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

Application window anticipated to close:

1/5/2027 The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

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