Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

Job Details

Location: Remote, USA

Program Hours: 8:00 am - 9:00 pm EST, must be available to work any shift during these hours

• Master of all standard and advanced services and willing to perform them as needed for the good of our patients. Including but not limited to:
  • Billing and coding support
  • Claims assistance, tracking and submission
  • Prior authorization assistance and tracking
  • Coordination of benefits
  • Benefit verification result call
  • Welcome calls g. Advanced alternate coverage research
  • Appeals/Denials
  • Inbound Phone Queue/General Program Inquires
  • Determination for support programs (Copay, PAP, Medicaid, etc.)
  • Pharmacy triage and coordination
  • Order processing for wholesale orders
  • Other follow-up activities (missing info, prior authorization, etc.)
  • Intakes and reports adverse events as directed.
  • Non-Clinical adherence services
• Engages with manufacturer representatives around items like payer profiles, reimbursement trends, issues with specific offices etc.
• Responsible for coordination of services with field reimbursement teams and sales representatives.
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
• Independently analyzes, reports, resolves, and communicates any reimbursement trends/delays (e.g. billing denials, claim denials, pricing errors, payments, etc.).
• Processes any necessary correspondence.
• Coordinates with internal and external service providers to ensure services are performed in accordance with program policy and within expected service level agreements (SLA).
• Provides training and support to internal associates.
• Fields questions from program representatives and specialist.
• Handles initial customer escalations.
• Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate.
• Independently and effectively resolves complex accounts with minimal supervision.
• Maintains confidentiality in regards to all patient sensitive information.
• Works on complex issues where analysis of situations or data requires in-depth evaluation of variable factors. Exercises judgment in selecting methods, techniques and evaluation criteria for obtaining results. Networks with key contacts outside own area of expertise.
• Acts independently to determine methods and procedures on new or special assignments.
• Performs related duties and special projects as assigned.

Experience and Educational Requirements:

High school diploma or GED required. Requires broad training in fields such as business administration, accounting, computer sciences, medical billing and coding, customer service or similar vocations generally obtained through completion of a two-year associate’s degree program, technical vocational training, or equivalent combination of experience and education. Five years (5) + years directly related and progressively responsible experience required. A two-year degree can be used in lieu of 2 years of the experience requirement, a four-year degree in lieu of 4 years of experience. Four-year degree preferred.

Minimum Skills, Knowledge and Ability Requirements:

• Ability to communicate effectively both orally and in writing.
• Ability to build productive internal/external working relationships.
• Advanced interpersonal skills.
• Strong mathematical skills.
• Basic analytical skills.
• Advanced organizational skills and attention to detail.
• Extensive knowledge of pharmacy operations and medical claims.
• Excellent use of medical industry vernacular.
• General knowledge of health care billing required. Advanced knowledge preferred.
• Advanced use Microsoft Excel, Outlook and Word.
• Developing professional expertise; applies company policies and procedures to resolve a variety of issues

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to tradit