Job Description

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:

This role will be onsite supporting Thompson Infusion Services at Oak Ridge dept of FSRMC

Shift Time: 8:00AM-4:30PM EST

Responsibilities:

Evaluate data input schedules from facilities to load work itemsCollaborate with facility EHR’s to gather data to support diagnosis and medical clearancesIdentify advocacy opportunities as it pertains to patient specific situations and insurance statusApply proper clearance criteria for medication regimens as insurance indicatesDiscuss medication options with pharmacy/physician and patient based on accessibility and availability (outpatient environment)Initiate and process applications for advocacy opportunities for qualifying patientsExtensive contact with insurance companies to include speaking to representatives for benefit investigation as well as clinical clearance for prior authorization and medical necessityExtensive patient education/counseling to determine eligibility for Advocacy.Identify and resolve rejected applications, including accessing comparable drug regimenRefer patients that do not qualify for programs to other outside assistance. I.e. local charitiesManage the drug recovery application processAssign appropriate billing level to each item processed in accordance with Reimbursement Solution guidelinesCommunicate with team lead to meet the needs of the assigned facilityMaintain 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 servicesInfluences customer decision to purchase new products and servicesLeads the post-sales assessment, design, implementation and monitoring of new products and services in multi-site and/or complex environmentsDevelops, plans and manages customer training programs in multi-site and/or complex environmentsServes as lead consultant and resource to internal and external customers in multi-site and/or complex environmentsMentors internal staff regarding best demonstrated practicesSignificantly influences customer acceptance and utilization of new products and services in multi-site and/or complex environmentsInitiates 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 learnStrong analytical skills preferredMust be self-motivated and have the ability to understand and follow instructionsStrong Microsoft Office skills (Excel, Word, Outlook)Strong written and verbal communicationAble to work independently and solve problems on behalf of Cardinal and the customerMust be able to prioritize work to maximize job effectivenessExcellent interpersonal skillsStrong ability to work under pressure and meet deadlinesStrong telephone presence/etiquette

What is expected of you and others at this level

Applies basic concepts, principles, and technical capabilities to perform routine tasksWorks on projects of limited scope and complexityFollows established procedures to resolve readily identifiable technical problemsWorks under direct supervision and receives detailed instructionsDevelops 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 coveragePaid time off planHealth savings account (HSA)401k savings planAccess to wages before pay day with myFlexPayFlexible spending accounts (FSAs)Short- and long-term disability coverageWork-Life resourcesPaid parental leaveHealthy lifestyle programs

Application window anticipated to close: 3/13/2025*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.

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