Care Coordinator

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

📋 Description

• Take ownership of patient cases from initiation through to closure.

• Conduct benefit investigations and manage prior authorizations along with denial appeals.

• Assess financial eligibility for assistance programs.

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

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

• Execute program welcome calls and follow-up calls after benefit investigations.

• Clarify coverage options to both patients and healthcare providers.

• Handle client and healthcare provider inquiries in accordance with program guidelines.

• Manage incoming calls and direct patients to the appropriate resources.

• Offer personalized case management while communicating benefit coverage and subsequent steps.

• Identify benefits and payer coverage utilizing electronic tools and manual investigation methods.

• Communicate requirements for prior authorization, appeals, tier exceptions, and formulary exclusions.

• Follow up with payers and healthcare providers regarding submissions and their outcomes.

• Coordinate nurse education, follow-ups, adherence services, and peer support resources.

• Oversee product shipments through patient assistance and bridge programs.

• Manage re-verification of prior authorizations and re-enrollment needs for patient assistance.

• Report adverse events, product complaints, special situation reports, and medical inquiries.

• Document activities within the PharmaCord Lynk system.

• Adhere to SOPs, business rules, corporate policies, and training deadlines.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

• Bachelor’s degree is highly preferred, or equivalent experience is required.

• Customer service experience and familiarity with the healthcare industry are preferred but not mandatory.

• Availability to work an 8.5-hour shift between 8 am and 9 pm, Monday to Friday.

• Basic computer proficiency.

• Ability to effectively multitask.

• Clear and concise communication skills.

• Professional telephone etiquette.

• Attention to detail.

• Must satisfy all work-from-home criteria; remote eligibility is based on business needs.

• A typing speed of at least 35 words per minute with 97% accuracy is preferred.

• Willingness to travel as required is preferred.

• Successful completion of a background check and, depending on the position, a drug screening.

• Bilingual skills in Spanish and English are advantageous.

🏝️ 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 on Health Savings Account contributions.

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

• Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability.

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

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays along with two floating holidays.

• Opportunities for career advancement and personal as well as professional development.

• A challenging and stimulating work environment that encourages new ideas.

• An inclusive workplace and mission-driven culture.

• Minimal travel flexibility is preferred.