Remote Care Access Coordinator: Payer Support

Cardinal Health, Inc.; Dallas (TX); Remote; USD 29,000 - 43,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401k plan

HSA

FSAs

Disability insurance

Paid time off

Parental leave

Wellness programs

Job summary

Cardinal Health Sonexus Health provides a remote, full-time Case Manager role focused on patient access to therapy through reimbursement support services. You will guide healthcare providers through intake, prior authorizations, and step-therapy reviews, coordinating with payers, pharmacies, and support organizations to ensure timely delivery of therapy.

Ideal candidates have experience with health insurance benefit investigations, Medicare/Medicaid knowledge, and strong attention to detail.

Qualifications

• High School Diploma, GED, or equivalent work experience.
• 3-6 years experience in related field preferred
• 1-2 years experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred
• Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
• Critical and creative thinking, preferred
• Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred
• Knowledge of Medical/Pharmacy billing and coding is preferred
• Important to have a strong attention to detail

Responsibilities

• The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the healthcare providers through the various process steps in support of their patient's journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up with various partners including the insurance payers, specialty pharmacies, and support organizations to facilitate coverage and delivery of product in a timely manner.
• Must demonstrate efficiency and strong organizational skill
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
• Proactive follow-up with various contacts to ensure patient access to therapy
• Call interactions are inbound & outbound: Must demonstrate superior customer support talents that remain in compliance with standard call quality expectations.
• Must communicate clearly and effectively in both a written and verbal format
• Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program.

Job description

Cardinal Health Sonexus Health provides a remote, full-time Case Manager role focused on patient access to therapy through reimbursement support services. You will guide healthcare providers through intake, prior authorizations, and step-therapy reviews, coordinating with payers, pharmacies, and support organizations to ensure timely delivery of therapy.

Ideal candidates have experience with health insurance benefit investigations, Medicare/Medicaid knowledge, and strong attention to detail.