Reimbursement Coordinator

Cardinal Health

2d•$23 - $30•Remote

About The Position

The Reimbursement Coordinator supports patients and programs by handling inbound inquiries, processing enrollment applications, reviewing documentation, and maintaining detailed records of patient interactions. The role helps patients understand and access coverage and financial assistance, completes benefit investigation activities, and works to resolve payer, provider, and pharmacy issues. It also follows up on benefit investigation rejections, including prior authorizations and appeals, and communicates escalations and payer trends to management. This is a full-time remote position (40 hours per week). The employee must be available to work any shift schedule during normal business hours, Monday through Friday, 8:00 a.m. to 5:00 p.m. CST. New-hire training is scheduled from 8:00 a.m. to 5:00 p.m. CST and requires camera attendance. The employee must work in a dedicated, quiet, private, distraction-free environment and provide a qualifying high-speed internet connection. Cardinal Health provides the computer, technology, and equipment needed for the job.

Requirements

Ability to work in high-volume production teams with an emphasis on quality.
Intermediate to advanced computer skills and proficiency with Microsoft Office, including Word and Outlook; Excel capability is preferred.

Nice To Haves

3–6 years of experience.
High school diploma, GED, or equivalent work experience.
Patient Support Service experience.
Clear knowledge of Medicare (Parts A, B, C, and D), Medicaid, and commercial payer coverage policies and guidelines.
Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices.
Clear understanding of medical, supplemental, and pharmacy insurance benefit practices.
1–2 years of experience submitting prior authorizations and appeals.
Previous medical experience.
Adaptability and flexibility.
Self-motivation and dependability.
Strong problem-solving ability.
Bilingual ability.

Responsibilities

Serve as the first point of contact for inbound calls, determine callers’ needs, and handle inquiries appropriately.
Create and complete accurate enrollment applications promptly.
Review forms and supporting documents for missing or new information and update the database as needed.
Conduct outbound correspondence to support patient and program needs.
Resolve patient and patient-representative questions and concerns about the status of assistance requests.
Maintain accurate, detailed notes for every interaction in the appropriate database.
Call patients and providers to discuss missing information or benefit-related information.
Assess patients’ ability to afford therapy and guide them to appropriate financial assistance.
Document the appropriate actions needed for benefit investigation processing.
Work with teammates to support the needs of the patient population.
Follow through on benefit investigation rejections, including prior authorizations and appeals, exhausting available avenues to obtain product coverage.
Track payer and plan issues and report changes, updates, and trends to management.
Research insurance options and explain programs to patients to help them select suitable coverage.
Handle escalations based on region and communicate resolutions within the timeframe agreed upon with the client.
Research issues involving payers, physician offices, and pharmacies to resolve them promptly.