Representative, Customer Service - Insurance Verification

Cardinal Health, Inc.; United States; Remote; Full time

Job summary

A leading healthcare company is seeking a Customer Service Operations Specialist to manage insurance verifications and billing issues. The ideal candidate will have experience in healthcare insurance and strong problem-solving skills. This role offers a supportive work environment with comprehensive benefits.

Benefits

Medical, dental and vision coverage

Paid time off plan

Health savings account (HSA)

401k savings plan

Flexible spending accounts (FSAs)

Short- and long-term disability coverage

Paid parental leave

Qualifications

• Minimum of 2 years of experience in healthcare insurance verification or related role preferred.
• Advanced knowledge of medical insurance terminology, policies, and procedures.

Responsibilities

• Conducts in-depth insurance verifications for complex cases.
• Collaborates with insurance carriers to address inquiries and resolve issues.
• Investigates and resolves complex insurance-related billing issues.

Skills

Medical Insurance Terminology

Problem Resolution

Communication

Education

High School Diploma or GED

Tools

EHR Systems

Insurance Verification Software

Microsoft Office

Job description

Schedule: Monday - Friday, 8am - 4:30pm - ideal candidate resides in Eastern Time Zone or Central Time Zone

What Customer Service Operations contributes to Cardinal Health
Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution.

Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution

Responsibilities:

• Conducts in-depth insurance verifications for complex cases, such as multiple insurance coverages or specialized procedures.
• Researches and interprets insurance policies and benefits to determine coverage and eligibility for medical services.
• Collaborates with insurance carriers and healthcare providers to address insurance-related inquiries and resolve issues.
• Manages the pre-authorization process for high-level medical procedures and services, ensuring compliance with payer requirements.
• Advocates for patients to obtain necessary authorizations and navigate insurance coverage challenges.
• Evaluates authorization denials and appeals, providing documentation and support as needed.
• Reviews and analyzes insurance claims for accuracy and completeness before submission.
• Investigates and resolves complex insurance-related billing issues and claim rejections.
• Provides guidance and training to junior insurance verification specialists on billing procedures and best practices.
• Assists in conducting audits of insurance verification processes to ensure compliance with industry standards and regulations.
• Identifies opportunities for process improvements and recommend solutions to enhance efficiency and accuracy.
• Serves as a subject matter expert on insurance verification policies and procedures.
• May perform any additional responsibilities or special projects as required.
• May provide cross-functional support as business needs demand.
• Duties and responsibilities may be subject to change based upon the needs of the department.

Qualifications:

• High school diploma or equivalent (GED preferred.
• Minimum of 2 years of experience in healthcare insurance verification or related role preferred.
• Advanced knowledge of medical insurance terminology, policies, and procedures.
• Skilled in using EHR systems, insurance verification software, and Microsoft Office applications.
• Ability to remain in a stationary position most of the time (stand or sit).
• Ability to occasionally lift and/or move up to 15 pounds.

What is expected of you and others at this level

• Applies acquired job skills and company policies and procedures to complete standard tasks
• Works on routine assignments that require basic problem resolution
• Refers to policies and past practices for guidance
• Receives general direction on standard work; receives detailed instruction on new assignments
• Consults with supervisor or senior peers on complex and unusual problems

Anticipated hourly range:$15.00 per hour - $22.57 per hour

Bonus eligible:No

Benefits:Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• 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:07/11/2025 *if interested in opportunity, please submit application as soon as possible.

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.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

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/Affirmative Action 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.