Reimbursement Coordinator

Title: Reimbursement Coordinator

(Patient Assistance and Support)

Location: Nationwide United States

Job Description:

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

Location - Fully remote, open to candidates in various time zones across the country (with expectation that individual can work within our standard business hours, 8:00am Central - 5:00pm Central)

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 o Will transfer caller to appropriate team member (when applicable)
• 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. 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
• Serve as a liaison between client sales force and applicable party
• Mediate 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
• As needed conduct research associated with issues regarding the payer, physician's office, and pharmacy to resolve issues swiftly

Qualifications

• Ideally targeting individuals with a background in healthcare (such as medical assistant, working in medical claims/billing, pharmacy technician, clinician in a doctor's office, etc) or with insurance verification - highly preferred
• Ideally targeting individuals with a high level of attention to detail, eagerness to learn, willingness to collaborate and communicate effectively
• Ability to work in an environment that involves a high volume of varying tasks (must be willing to be flexible and wear a lot of different hats, without getting overwhelmed), required
• Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers' policies and guidelines for coverage, preferred
• Knowledge of DME, MAC practices, preferred
• Prior understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred
• Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and preferred Excel capabilities
• Bilingual, preferred

What is expected of you and others at this level

• Investigate and resolve patient/physician inquiries and concerns in a timely manner
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
• Must be able to manage multiple concurrent assignments.
• Must communicate clearly and effectively in both a written and verbal format
• Proactive follow-up with various contacts to ensure patient access to therapy
• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
• In-depth knowledge in technical or specialty area
• Applies advanced skills to resolve complex problems independently
• May modify process to resolve situations
• Works independently within established procedures; may receive general guidance on new assignments
• May provide general guidance or technical assistance to less experienced team members
• Adaptable and Flexible
• Self-Motivated and Dependable
• Problem Solving
• Strong customer support skills and professional experience working with medical providers
• Team Spirited
• Punctual and Efficient
• Great work attitude

Anticipated hourly range: $21.50 per hour - $27.70 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: 7/4/2026 *if interested in opportunity, please submit application as soon as possible.

The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

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.

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