Reimbursement Coordinator

Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions—driving brand and patient markers of success. We’re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.

Together, we can get life-changing therapies to patients who need them—faster.

What Individualized Care contributes to Cardinal Health

Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Individualized Care provides care that is planned to meet the particular needs of an individual patient.

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

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

Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred

Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, 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 but not limited to Word, Outlook, and preferred Excel capabilities