Specialty Pharmacy Benefits Coordinator

What Individualized Care contributes to Cardinal Health

The Senior Coordinator, Individualized Care position is responsible for full benefit investigation including processing prior authorizations and working with physician offices to facilitate the appeal process. This position must ensure the insurance verification related to patient prescriptions are processed accurately, efficiently, and timely in complete accordance with all applicable laws, regulations and company policies. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy.

Hours: 8am-4:30pm Monday-Friday

What is expected of you and others at this level

• 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

Responsibilities:

• Contact insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections

• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate

• Demonstrate superior customer support talents

• Prioritize multiple, concurrent assignments and work with a sense of urgency

• Must communicate clearly and effectively in both a written and verbal format

• Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.

Qualifications

• Previous customer service experience required

• High School diploma or equivalent preferred

• Bachelors degree preferred

• Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals is a must (1-2 years)

• Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies is a must

• Critical and creative thinking is a must

• Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred

• Knowledge of Medical/Pharmacy billing and coding is preferred

• Knowledge of 340B is preferred

• Important to have a strong attention to detail

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.