Remote Reimbursement & Benefits Specialist

Cardinal Health, Inc.; Boise (ID); Remote; USD 32.000 - 41.000; Vollzeit

Benefits dieser Stelle

Medical, dental and vision coverage

Paid time off

401k savings plan

HSA

Zusammenfassung

Cardinal Health is seeking a remotely based Customer Service Specialist within Individualized Care to support enrollment, benefit investigations, and patient assistance. You will handle inbound calls, verify information, and guide patients through enrollment while coordinating with payers and providers.

Training runs 8:00am-5:00pm CST and the role is full-time remote (40 hours/week) with flexibility to work during our standard business hours.

Qualifikationen

• 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 Word, Outlook, and Excel
• Previous medical experience is preferred
• Adaptable and Flexible, preferred
• Self-Motivated and Dependable, preferred
• Strong ability to problem solve, preferred
• Bilingual is preferred

Aufgaben

• 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

Kenntnisse

Customer service

Problem solving

Communication

Multitasking

MS Office proficiency

Phone communication

Bilingual (preferred)

Ausbildung

High School Diploma, GED, or equivalent

Tools

Microsoft Word

Outlook

Excel

Jobbeschreibung

Cardinal Health is seeking a remotely based Customer Service Specialist within Individualized Care to support enrollment, benefit investigations, and patient assistance. You will handle inbound calls, verify information, and guide patients through enrollment while coordinating with payers and providers.

Training runs 8:00am-5:00pm CST and the role is full-time remote (40 hours/week) with flexibility to work during our standard business hours.