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[Remote] Senior Representative, Customer Service - Authorizations
Note: The job is a remote job and is open to candidates in USA. Cardinal Health is a company that specializes in providing outsourced services related to medical billing and reimbursement. They are seeking a Senior Representative, Customer Service – Authorizations to manage medical authorization requests for DME products, ensuring patients receive critical supplies while providing exceptional service to stakeholders.
Responsibilities
- Completes and manages medical authorization requests for DME products, including CGM and pump supplies, using three primary submission methods: payer portals, phone calls, and fax
- Performs validation steps, including verifying documentation, confirming coverage, reviewing coding (ICD‑10, HCPCS), and ensuring completeness prior to submission
- Monitors and follows up on authorization status via payer portals, inbound/outbound calls, and fax replies
- Resolves authorization denials by coordinating with prescribers, payers, and internal partners; resubmits corrected or additional documentation when required
- Communicates professionally with patients, providers, medical groups, and payers to clarify requirements, request missing information, and provide status updates
- Collaborates with Order Fulfillment teams to ensure timely creation of work orders and product dispensing once authorization is approved
- Documents all activities accurately and meets established SLA timeframes, including 24‑hour turnaround expectations for assigned work
- Handles inbound and outbound calls (average 5–15 per day) regarding authorizations, status checks, and escalations
- Supports grievance or escalation handling by demonstrating ownership of outcomes and prioritizing patient impact
- Identifies workflow bottlenecks or payer‑specific issues and escalates as needed to leadership for process improvement opportunities
- Acts as a resource to peers, providing support aligned with the expectations of a senior‑level representative and assisting leadership with team coordination when needed
Skills
- 3-6 years of experience, preferred
- High School Diploma, GED or equivalent work experience, preferred
- Understanding of insurance authorization processes
- Basic knowledge of ICD‑10 and HCPCS coding
- Knowledge of insurance verification procedures and DME authorization workflows
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
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