Nationwide, US, United States of America
16 hours ago
Advisor, Payer Rules & Credentialing

Remote Hours: Monday - Friday, 7:00 AM - 3:30 PM CST (or based on business need)

What Customer Service Operations contributes to Cardinal Health


Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution.

Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution

Responsibilities

Analyzes and monitors payer trends, managed care contract compliance, contract and payer yield and indicators that reflect new opportunities for revenue or charge capture, operational improvements and increased reimbursement.

Performs accurate and timely accounts receivable management

Analyzes accounts receivable transactions to ensure compliance with internal controls and accounting policies

Maintains and reconciles accounts receivable ledger and prepares management reports, including reports of delinquent accounts

Analyzes trends in bad debts and recommends improvements to accounts receivable policies and procedures

Works closely with all Revenue Cycle Departments and Managed Care

Coordinates with departments and insurance companies to correct errors as necessary

Documents and tracks all revenue cycle payer issues

Leads payer contract loads for underpayment recovery

Conducts analysis and outcome assessments on issue report

Communicates changes and prepares weekly reports that assist Revenue Cycle leadership

Maintains all documentation for the Payer Relations Team within Revenue Cycle to include Revenue Cycle Payer Relations emails via Resource Box in MS Outlook

Coordinates payer visits to learn about any portal enhancements, guidelines updates, contract updates

Assists with payer in-service training upon request

Audits proper use of account resolution from identification stage through resolution

Monitors reimbursement regulations

Maintains knowledge of current legislation concerning HMO appeals on both national and state level

Ensures appropriate coverage for compliance standards and revenue generation

Participates in management and other meetings as necessary

Attends all payer JOC (joint operating committee) meetings and represents the organization at the state level by attending statewide payer teleconference meetings with CMS, AA Homecare and HFMA

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary

Meets company quality standards.


 

Qualifications

HS, GED, bachelor’s degree in business related field, or equivalent work experience preferred

4+ years of relevant experience preferred

Knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices

Full knowledge all areas of collections specialization preferred

Proficiency in Excel, basic math and business calculations

Working knowledge of computer/data entry with the ability to learn new systems

Advanced level of MS Office (Excel) proficiency preferred

Any appropriate combination of relevant education, experience and/or certifications may be considered



What is expected of you and others at this level

Applies comprehensive knowledge and understanding of concepts, principles, and technical capabilities to perform varied tasks and projects

Develops innovative technical solutions to a wide range of difficult problems aligned with organizational objectives

Independently completes work with general guidance; work is reviewed to ensure alignment with objectives

May contribute to the development of policies and procedures

Resolves highly escalated collections issues or concerns

Cross-trained on all collections processes

Demonstrates effective analytical skills using inductive and deductive reasoning to anticipate outcomes

Proactively identifies challenges and applies a solution-oriented approach to problem solving

Communicates in a friendly, professional, and effective manner; able to calmly present solutions in challenging situations

Collaborates effectively with cross-functional teams; influences others through strong interpersonal skills

Provides mentorship and training to less experienced colleagues as needed

Manages and prioritizes multiple tasks/projects, works autonomously, and meets deadlines

Works well in a team environment that promotes inclusiveness and open communication

Demonstrates service orientation and aptitude to resolve insurance and/or patient matters

Exhibits self-directed accountability and reliability

Works on complex projects of large scope

Anticipated salary range:  $67,500 - $ 96,300 per year

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

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


 

Application window anticipated to close: 11/14/2025 *if interested in opportunity, please submit application as soon as possible.

The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

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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