Care Coordinator

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

📋 Description

• Manage patient cases from start to finish.

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

• Assess financial eligibility for assistance programs.

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

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

• Conduct program welcome calls and follow-up calls post-benefits investigation.

• Clarify coverage options for patients and physicians.

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

• Receive inbound calls and direct patients to the appropriate resources.

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

• Identify payer benefits and coverage using electronic tools and manual research.

• Relay prior authorization, appeal, tier exception, and formulary exclusion requirements.

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

• Coordinate nurse education, follow-up, peer support, and product shipments.

• Handle prior authorization reverification and patient assistance re-enrollment requirements.

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

• Document all activities within the PharmaCord Lynk system.

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

• Execute additional assigned tasks or projects.

⛳️ Requirements

• Bachelor's degree strongly preferred or equivalent experience required.

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

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

• Basic computer proficiency.

• Attention to detail.

• Professional telephone etiquette.

• Effective multitasking abilities.

• Clear and concise communication skills.

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

• Bilingual skills in Spanish and English are an advantage.

• Flexibility to travel as needed is preferred.

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

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

🏝️ Benefits

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

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

• Company match on Health Savings Account contributions.

• Complimentary 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 plus two floating holidays.

• Opportunities for career advancement and personal and professional development.

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

• An inclusive workplace and mission-driven culture.

• Background check and, depending on the position, drug screen as conditions of employment.