Care Coordinator

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

📋 Description

• Take ownership of patient cases from the beginning to the end.

• Conduct benefit investigations, obtain prior authorizations, appeal denials, and assess financial qualifications for assistance programs.

• Guide patients and stakeholders through resolutions via email, inbound/outbound calls, and Lynk technology.

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

• Maintain relationships in compliance with healthcare laws and regulations.

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

• Address client and healthcare professional inquiries per reporting requirements and business rules.

• Handle inbound calls using program-approved FAQs.

• Direct patients to appropriate internal or external resources.

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

• Identify benefits and payer coverage using both electronic tools and manual investigations.

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

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

• Coordinate nurse education and follow-up services.

• Identify resources for peer support.

• Manage product shipments through patient assistance and bridge programs from the PharmaCord pharmacy.

• Communicate the need for prior authorization reverification or re-enrollment in patient assistance programs.

• Report adverse events, product complaints, special situation reports, and medical inquiries as per SOPs and business rules.

• Log activities in the PharmaCord Lynk system.

• Meet training deadlines and adhere to SOPs.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

• Strong attention to detail.

• Professional telephone etiquette.

• Self-awareness regarding your emotions and their potential impact on others.

• Basic computer skills.

• Ability to effectively multitask.

• Capability to recognize emotions and their impacts.

• Confidence in self-worth and abilities.

• Ability to manage disruptive impulses.

• Uphold standards of honesty and integrity.

• Take responsibility for your performance.

• Adapt to and handle change with flexibility.

• Be innovative and receptive to new ideas.

• Driven by achievement; consistently striving to improve or meet excellence standards.

• Align with the goals of the team or organization.

• Willingness to take initiative and seize opportunities.

• Maintain optimism and persistently pursue goals despite challenges and setbacks.

• Be service-oriented, anticipating, recognizing, and meeting the needs of others, including patients and care partners.

• Communicate clearly and concisely.

• Maintain a positive attitude!

• 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 advantageous.

• Remote work eligibility is contingent upon meeting all work-from-home criteria and based on business needs.

• Ability to regularly talk or hear; sit for extended periods; use hands to type, handle, or feel; and reach with hands and arms.

• Preference for candidates who can type at least 35 words per minute with 97% accuracy.

• Flexibility to travel as needed is preferred.

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

🏝️ Benefits

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

• Additional health support, including telehealth and Employee Assistance Program (EAP) services.

• Company match on Health Savings Account contributions.

• Free Basic Life and AD&D coverage equal to your 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 with a 100% match on the first 5% you contribute, with immediate vesting.

• Paid Time Off (PTO) and Sick Leave to promote work-life balance.

• Team members receive nine paid holidays plus two floating holidays.

• Opportunities for advancement in a company that encourages personal and professional growth.

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

• Work for a company that values diversity and actively seeks to create an inclusive workplace.

• A mission-driven, inclusive culture where your contributions have a meaningful impact.