Diabetes Supplies Claims Auditor

Summary

The Durable Medical Equipment Supplies Claims Auditor plays a key role in supporting Cardinal Health’s Ethics and Compliance program by helping ensure claims-related processes are accurate, compliant, and aligned with applicable payer and regulatory requirements. This role performs auditing and monitoring activities for diabetic supplies claims, including Continuous Glucose Monitors (CGMs), blood glucose monitoring products, insulin pumps, insulin pump supplies, testing supplies, and related diabetes care products. I dentifies trends and potential compliance risks, and partners with cross-functional teams. The ideal candidate is analytical, detail-oriented, collaborative, and comfortable working in a fast-paced healthcare environment where sound judgment, clear communication, and a commitment to continuous improvement are essential.

What Ethics & Compliance contributes to Cardinal Health

Ethics & Compliance promotes a culture that encourages ethical conduct and a commitment to compliance. This function implements strategies and processes to ensure adherence to policies, educates and trains employees across the organization, and conducts investigations to resolve ethics and compliance issues.

Ethics & Compliance develops and implements strategies and standard operating procedures to promote adherence to internal ethics and compliance policies related to areas such as privacy, HIPAA and FCPA, among others. This job family resolves concerns from business unit leaders and employees and proactively provides guidance and trainings on policies.

Responsibilities

• Perform compliance monitoring and auditing activities for a DMEPOS supplier, including post-payment claim reviews for diabetic care products and supplies, such as Continuous Glucose Monitors (CGMs), blood glucose monitors, testing supplies, insulin pumps, insulin pump supplies, lancets, and related diabetic equipment.
• Perform root cause analysis through review of claims, documentation, payer requirements, workflows, and operational processes to identify trends, compliance risks, and remediation opportunities. 
• Track results and trends and report findings to manager to support result dashboards 
• Clearly document and communicate risks, issues, root causes, customer impacts, and provide remediation recommendations.
• As applicable, attend in-service, continuing education or seminar programs to stay current with industry trends.
• Collaborate effectively across the organization to assist and advise on process improvements; gather support from colleagues and/or other key partners . 
• Assist in imple men ting monitoring procedures for claims related processes while collaborating cross-functionally with stakeholders to improve operational alignment and process improvement initiatives.
• Implement processes to ensure the c ollect ion of accurate auditing and monitoring data that will support a data driven compliance program and help identify areas of risk
• Adapt effectively to evolving priorities, regulatory requirements , and business processes within a fast-paced en vironment.

Qualifications

• Bachelor’s degree in related field, or equivalent work experience, preferred
• 3-5 years of related work experience supporting auditing and monitoring programs for diabetic supplies providers/suppliers, including experience with CGM, diabetes testing supplies, insulin pumps, and related medical necessity requirements, preferred.
• Strong knowledge and understanding of healthcare industry regulations and guidelines preferred (Federal Anti-Kickback, False Claims, Stark Law, Beneficiary Inducement Statute)
• Strong knowledge of Medicare Local Coverage Policies, Med icaid manuals, and other insurance billing requirements. 
• Strong organizational skills with the ability to support multiple projects in a fast-paced environment
• Ability to create and communicate data-based findings and information effectively to non-technical audiences
• Related work experience with Brightree, preferred
• Strong communication and presentation skills
• Proficiency in MS Word, Excel, PowerPoint, and Outlook
• Will be working EST business hours

What is expected of you and others at this level

• Applies principles, and technical capabilities to perform varied auditing and monitoring tasks
• Ability to learn different system technologies and support audits of these platforms
• Works on special projects of moderate scope and complexity
• Ability to interpret various payor rules and policies for auditing and monitoring 
• Identify possible solutions to a variety of technical findings and take action to recommend remediation strategies
• Applies sound judgement within defined parameters
• Completes work independently with ability to implement action plans based on general guidance 
• Receives general guidance and may receive more detailed instructions on new projects
• Work reviewed for sound reasoning and accuracy
• Ability to work collaboratively 
• Customer oriented attitude and seek to understand approach to helping others
• Strong analytical, organizational, written and verbal communication skills.

Anticipated hourly range: $33/hr - $37.68/hr

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: 10/05/2026 *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.