Care Coordinator

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Manage patient cases from the beginning to the end.

• Carry out benefit investigations along with prior authorizations and denial appeals.

• Assess financial eligibility for assistance programs.

• Support patients, callers, and stakeholders in resolving issues through email, inbound/outbound calls, and Lynk technology.

• Establish trusted connections with patients, prescribers, and client stakeholders.

• Conduct welcome calls and follow-up calls post-benefits investigation to discuss coverage options.

• Address client and HCP inquiries in compliance with reporting requirements and business regulations.

• Handle incoming calls and direct patients to suitable internal or external resources.

• Offer tailored case management services to patients and HCPs.

• Determine benefits and payer coverage through electronic tools and manual research.

• Relay information on benefit coverage, prior authorization, appeals, tier exceptions, and formulary exclusions.

• Follow up with payers and HCPs regarding submissions and their outcomes.

• Coordinate nurse education and follow-up for adherence services.

• Identify resources for peer support.

• Oversee product shipments through patient assistance and bridge programs.

• Communicate needs for prior authorization reverification and patient assistance re-enrollment.

• Report adverse events, product complaints, special situation reports, and medical inquiries in accordance with SOPs and business policies.

• Complete corporate policy and procedure training punctually.

• Adhere to all SOPs consistently.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

• Preferred experience in customer service and the healthcare sector, though not mandatory.

• Ability to work an 8.5-hour shift between 8 am and 11 pm, Monday to Friday.

• Bilingual skills in English and Spanish or Chinese/Mandarin are advantageous.

• Capacity to talk, hear, sit for extended periods, type, manipulate objects, and reach with hands and arms.

• Desired typing speed of at least 35 words per minute with 97% accuracy.

• Flexibility to travel as required is preferred.

• Proficiency in using standard office equipment such as computers, phones, and photocopiers.

• Successful completion of a background check and, if applicable, a drug screening.

🏝️ Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing to premium costs.

• Access to Telehealth and Employee Assistance Program (EAP) services.

• Company matching contributions on Health Savings Account deposits.

• Complimentary Basic Life and AD&D coverage equivalent to annual earnings, with a minimum of $50,000 and a maximum of $300,000.

• Company-funded Short-Term Disability coverage, with the option to buy Long-Term Disability.

• 401(k) Retirement Savings Plan with a 100% match on the first 5% contributed, with immediate vesting.

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for growth and advancement, both personally and professionally.

• A dynamic work environment that fosters new ideas.

• An inclusive workplace with a mission-driven culture.

• Meaningful work that supports patient care.

• Comprehensive benefits for full-time employees.