Senior Representative, Customer Service - Authorizations

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.

Job Summary

The Senior Representative, Customer Service – Authorizations is responsible for managing end‑to‑end medical authorization requests to ensure patients receive critical DME products, including CGMs, insulin pump supplies, and other related equipment. This role performs authorization submission, status management, and resolution of denials across multiple payer channels (phone, portal, and fax) while delivering exceptional service to patients, providers, and payer partners.

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

Qualifications

• 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

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

Anticipated hourly range: $16.75 per hour - $21.75 per hour

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