Headquartered in Dublin, Ohio, Cardinal Health, Inc. (NYSE: CAH) is a global, integrated healthcare services and products company connecting patients, providers, payers, pharmacists and manufacturers for integrated care coordination and better patient management. Backed by nearly 100 years of experience, with more than 40,000 employees in nearly 60 countries, Cardinal Health ranks among the top 20 on the Fortune 500.
We currently have a career opening for a Reimbursement Solutions Analyst.
What Clinical Operations contributes to Cardinal Health
Clinical Operations is responsible for supporting the timely and quality sale, installation and monitoring of Cardinal Health products and services may also provide product and service education to facilitate technology adoption and workflow change management.
The primary purpose of this position is to oversee the 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. Reports to Reimbursement Solutions Supervisor, Individualized Care
Location/Time Zone Support:
Remote. This role will generally support customers within a candidate's time zone.
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 (outpatient environment)
Initiate and process applications for advocacy opportunities for qualifying patients
Extensive contact with insurance companies to include speaking to representatives for benefit investigation as well as clinical clearance for prior authorization and medical necessity
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. I.e. local charities
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 per the Reimbursement Solution procedures.
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 in multi-site and/or complex environments
Develops, plans and manages customer training programs in multi-site and/or complex environments
Serves as lead consultant and resource to internal and external customers in multi-site and/or complex environments
Mentors internal staff regarding best demonstrated practices
Significantly influences customer acceptance and utilization of new products and services in multi-site and/or complex environments
Initiates discussion to obtain in-depth customer feedback for product and service improvement opportunities
Qualifications
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
Must be self-motivated and have the ability to understand and follow instructions
Strong Microsoft Office skills (Excel, Word, Outlook)
Strong written and verbal communication
Able to work independently and solve problems on behalf of Cardinal and the customer
Must be able to prioritize work to maximize job effectiveness
Excellent interpersonal skills
Strong ability to work under pressure and meet deadlines
Strong telephone presence/etiquette
What is expected of you and others at this level
Applies basic concepts, principles, and technical capabilities to perform routine tasks
Works on projects of limited scope and complexity
Follows established procedures to resolve readily identifiable technical problems
Works under direct supervision and receives detailed instructions
Develops competence by performing structured work assignments
Pay rate: $27.00 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 : 1/19/2025*if interested in opportunity, please submit application as soon as possible.
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.
To read and review this privacy notice click here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)
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