Care Coordinator

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

📋 Description

• Take ownership of patient cases from start to finish.

• Conduct benefit investigations and handle prior authorizations or denial appeals.

• Assess financial eligibility for assistance programs.

• Provide support to patients and stakeholders through resolution via email, inbound/outbound calls, and Lynk technology.

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

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

• Address client and healthcare provider inquiries in accordance with reporting requirements and business rules.

• Manage incoming calls using program-approved FAQs.

• Direct patients to internal or external resources as needed.

• Offer personalized case management and communicate about benefit coverage and next steps.

• Identify benefits and payer coverage through electronic tools and manual investigations.

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

• Follow up with payers and healthcare providers concerning benefit coverage submissions and results.

• 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 program re-enrollment.

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

• Document activities in the PharmaCord Lynk system.

• Adhere to SOPs and meet required training deadlines.

• Perform any additional assigned tasks or projects.

⛳️ Requirements

• Strong attention to detail.

• Professional telephone communication skills.

• Fundamental computer proficiency.

• Capability to multitask efficiently.

• Clear and effective communication skills.

• A positive mindset.

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

• Experience in customer service and the healthcare industry is preferred but not mandatory.

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

• Bilingual abilities in Spanish and English are advantageous.

• Must meet work-from-home criteria for remote work eligibility.

• Ability to talk, hear, sit for extended periods, and use hands for typing and handling tasks.

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

• Flexibility to travel as necessary is preferred.

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

🏝️ Benefits

• Comprehensive medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing towards premium expenses.

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

• Company matching on Health Savings Account contributions.

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

• Company-sponsored Short-Term Disability coverage, with an option to purchase Long-Term Disability.

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

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for career advancement and personal and professional development.

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

• An inclusive workplace with a mission-driven culture.

• Remote work eligibility is subject to work-from-home criteria and business needs.