Reimbursement Solutions Analyst

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

Qualifications

• 0 - 2 years of experience in related field preferred
• 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

Pay

$27/hour

Benefits

• 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