Reimbursement Solutions Analyst

Cardinal Health

81d • $27

About The Position

Cardinal Health, Inc. is a global, integrated healthcare services and products company headquartered in Dublin, Ohio. We are currently seeking a Reimbursement Solutions Analyst. This position is primarily responsible for overseeing evaluation and clearance procedures and treatment orders in the contracted outpatient hospital setting. The goal is to provide a detailed outline of clearance criteria as well as prior authorization and advocacy identification for procedures and medications scheduled to be given in the outpatient hospital setting. The role involves extensive contact with insurance companies, patient education, and managing the drug recovery application process.

Requirements

• 0 - 2 years of experience in related field preferred (open to fresh graduates)
• High level of attention to detail and a willingness to learn
• Strong analytical skills preferred
• Self-motivated with the ability to understand and follow instructions
• Strong Microsoft Office skills (Excel, Word, Outlook)
• Strong written and verbal communication skills
• Ability to work independently and solve problems
• Ability to prioritize work to maximize job effectiveness
• Excellent interpersonal skills
• Ability to work under pressure and meet deadlines
• Strong telephone presence/etiquette

Responsibilities

• Evaluate data input schedules from facilities to load work items
• Collaborate with facility EHR’s to gather data to support diagnosis and medical clearances
• Identify advocacy opportunities as it pertains to patient specific situations and insurance status
• Apply proper clearance criteria for medication regimens as insurance indicates
• Discuss medication options with pharmacy/physician and patient based on accessibility and availability
• Initiate and process applications for advocacy opportunities for qualifying patients
• Extensive contact with insurance companies for benefit investigation and clinical clearance
• Extensive patient education/counseling to determine eligibility for Advocacy
• Identify and resolve rejected applications, including accessing comparable drug regimen
• Refer patients that do not qualify for programs to other outside assistance
• Manage the drug recovery application process
• Assign appropriate billing level to each item processed in accordance with Reimbursement Solution guidelines
• Communicate with team lead to meet the needs of the assigned facility
• Maintain daily accounting activities and prior authorization documentation
• Maintain security and confidentiality of patient information at all times
• Demonstrates extensive knowledge and understanding of relevant clinical operations, products and services
• Influences customer decision to purchase new products and services
• Leads the post-sales assessment, design, implementation and monitoring of new products and services
• Develops, plans and manages customer training programs
• Serves as lead consultant and resource to internal and external customers
• Mentors internal staff regarding best demonstrated practices
• Initiates discussion to obtain in-depth customer feedback for product and service improvement opportunities

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees