Remote Reimbursement Specialist

Cardinal Health, Inc.; Augusta (ME); Remote; USD 32,000 - 41,000; Full time

Job summary

Cardinal Health Sonexus Access and Patient Support is hiring for a remote, full-time Customer Service role focused on individualized care for patients in the US. You will manage enrollment applications, verify documentation, and assist patients with benefits and coverage, across high-volume calls and complex inquiries.

Ideal candidates have 3–6 years of experience with Medicare/payer policies, strong MS Office skills, and the ability to work independently in a remote setting.

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

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

Skills

Customer service

Medicare knowledge

MS Office

Payer policies understanding

High-volume multitasking

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

Cardinal Health Sonexus Access and Patient Support is hiring for a remote, full-time Customer Service role focused on individualized care for patients in the US. You will manage enrollment applications, verify documentation, and assist patients with benefits and coverage, across high-volume calls and complex inquiries.

Ideal candidates have 3–6 years of experience with Medicare/payer policies, strong MS Office skills, and the ability to work independently in a remote setting.