Reimbursement Coordinator

$44,720 - $63,752/Yr

Cardinal Health - Austin, TX

Full-time

Austin, TX

Merchant Wholesalers, Nondurable Goods

About the position

The Reimbursement Coordinator at Cardinal Health plays a crucial role in supporting patient access to therapy through Reimbursement Support Services. This position is responsible for guiding patients through their journey to therapy, which includes patient referral intake, investigating health insurance benefits, and following up with various partners to facilitate timely coverage and dispensing of products.

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
• 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
• Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance
• Update internal treatment plan statuses and external pharmacy treatment statuses
• Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry
• Self-audit intake activities to ensure accuracy and efficiency for the program
• Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information
• Notify patients, physicians, practitioners, and or clinics of any financial responsibility of services provided as applicable
• Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
• Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc.
• 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
• Serve as a liaison between client sales force and applicable party
• Mediates situations in which parties disagree and facilitate a positive outcome
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
• Responsible for reporting any payer issues by region with the appropriate team
• Log and maintain a reconciliation report for all Field requests to send to client at their designated preferred date range
• Support team with call overflow and intake when needed
• Conduct research associated with issues regarding the payer, physician's office, and pharmacy to resolve issues swiftly

Requirements

• Previous customer service experience is preferred
• High School diploma or equivalent preferred
• Patient Support Service experience, preferred
• Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers' policies and guidelines for coverage, preferred
• Knowledge of DME, MAC practices, preferred
• Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred
• 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience
• 1-2 years' experience with Prior Authorization and Appeal submissions
• Ability to work with high volume production teams with an emphasis on quality
• Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and preferred Excel capabilities
• Previous medical experience, preferred
• Bilingual is preferred

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