Patient Care Coordinator

2 weeks ago

East Montpelier, Vermont, United States Cardinal Health Full time

Overview of the Role

At Cardinal Health, we are dedicated to enhancing the patient experience through a unique model that integrates direct drug distribution with comprehensive pharmacy services, patient access support, and financial assistance programs. Our subsidiary, Sonexus Health, is committed to providing specialty pharmaceutical manufacturers with deeper insights into customer interactions and product performance.

Key Responsibilities

  • Serve as the initial contact for incoming inquiries, assessing needs and responding appropriately.
  • Efficiently complete enrollment applications, ensuring accuracy and urgency.
  • Thoroughly review documentation for completeness and update our database as necessary.
  • Conduct follow-up communications to support patient and program needs.
  • Address patient inquiries and concerns regarding their assistance requests.
  • Maintain and update treatment plan statuses for both internal and external stakeholders.
  • Document all interactions meticulously in the appropriate systems.
  • Perform self-audits on intake processes to ensure quality and efficiency.
  • Initiate outbound calls to clarify missing information or benefits.
  • Inform patients and healthcare providers about any financial responsibilities associated with services.
  • Evaluate patients' financial capabilities and guide them towards suitable financial assistance options.
  • Follow up on all benefit investigation denials, including prior authorizations and appeals.
  • Monitor payer issues and communicate any significant changes to management.
  • Assist patients in navigating insurance options and selecting the best coverage for their needs.
  • Manage escalated issues regionally, ensuring timely resolution communication.
  • Act as a liaison between the sales team and relevant parties.
  • Facilitate conflict resolution between parties to achieve positive outcomes.
  • Handle multiple ongoing issues simultaneously, ensuring timely resolutions.
  • Report regional payer issues to the appropriate teams.
  • Conduct research related to payer, physician, and pharmacy issues to expedite resolutions.

Expectations for Performance

  • Apply knowledge of company policies and procedures to complete various tasks effectively.
  • Demonstrate in-depth expertise in specialized areas.
  • Utilize advanced skills to independently resolve complex issues.
  • Modify processes as necessary to address unique situations.
  • Work autonomously within established guidelines, receiving general direction for new tasks.
  • Provide guidance and support to less experienced team members as needed.

Qualifications

  • Prior experience in customer service is preferred.
  • A high school diploma or equivalent is preferred.
  • Experience in patient support services is advantageous.
  • Familiarity with Medicare, Medicaid, and commercial payer policies is preferred.
  • Understanding of DME and MAC practices is a plus.
  • Knowledge of medical, supplemental, and pharmacy insurance benefits is preferred.
  • 1-2 years of experience in pharmacy or medical claims billing and coding is preferred.
  • 1-2 years of experience with prior authorization and appeals is preferred.
  • Ability to work effectively in high-volume environments with a focus on quality.
  • Proficiency in Microsoft Office applications, particularly Word and Excel.
  • Previous medical experience is preferred.
  • Adaptability and flexibility are preferred traits.
  • Self-motivation and reliability are essential.
  • Strong problem-solving skills are preferred.
  • Bilingual candidates are preferred.

Training and Work Schedule

New hire training will be conducted during standard business hours, with mandatory attendance required. This position is full-time, requiring flexibility to work various shifts during normal business hours.

Remote Work Requirements

This is a full-time remote position. A dedicated, quiet workspace with high-speed internet access is essential. The company will provide necessary technology and equipment.

Compensation and Benefits

Cardinal Health offers a comprehensive benefits package, including medical, dental, and vision coverage, paid time off, a 401k savings plan, and various health and wellness programs.

Cardinal Health is committed to fostering an inclusive workplace that values diversity and encourages all qualified applicants to apply.

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