Care Coordinator

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

📋 Description

• Take ownership of patient cases from start to finish.

• Execute benefit investigations and handle prior authorizations as well as denial appeals.

• Assess financial eligibility for assistance programs.

• Support patients, callers, prescribers, healthcare professionals (HCPs), and stakeholders through email and inbound/outbound calls.

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

• Conduct program welcome calls along with post-Benefits Investigation calls.

• Address client and HCP inquiries in accordance with business guidelines.

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

• Deliver tailored case management and communicate benefit coverage, along with next steps.

• Identify payer benefits and coverage utilizing both electronic tools and manual research.

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

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

• Coordinate nurse education and adherence follow-up efforts.

• Recognize peer support resources.

• Oversee product shipments through patient assistance and bridge programs.

• Manage prior authorization reverifications and patient assistance program re-enrollment needs.

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

• Document all activities in the Valeris Lynk system.

• Complete required training and adhere to corporate policies and SOPs.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

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

• Customer service and healthcare industry experience is preferred but not mandatory.

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

• Bilingual skills in Spanish and English are an advantage.

• Eligibility for remote work is contingent upon meeting all work-from-home criteria and business needs.

• Strong attention to detail is essential.

• Professional telephone etiquette is required.

• Basic computer skills are necessary.

• Ability to effectively multitask is important.

• Clear and concise communication skills are required.

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

• Successful completion of a background check and, depending on the position, a drug screen is necessary.

🏝️ Benefits

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

• Telehealth services and Employee Assistance Program (EAP) offerings.

• Company matching on Health Savings Account contributions.

• 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 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 plus two floating holidays.

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

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

• An inclusive workplace and mission-driven culture.

• Minimal travel flexibility is preferred.