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 manage prior authorizations as well as denial appeals.

• Assess financial eligibility for assistance programs.

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

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

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

• Outline coverage options for patients and healthcare providers.

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

• Manage incoming calls and direct patients to appropriate resources.

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

• Identify benefits and payer coverage utilizing electronic tools as well as manual investigations.

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

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

• Coordinate nurse education and follow-up services.

• Identify resources for peer support.

• Manage product shipments through patient assistance and bridge programs.

• Oversee prior-authorization reverification and re-enrollment needs for patient assistance.

• Report adverse events, product complaints, special situations, and medical inquiries in accordance with SOPs and business rules.

• Document all activities in the PharmaCord Lynk system.

• Meet training deadlines and adhere to SOPs.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

• Availability for the 11:30 AM–8 PM ET shift is mandatory.

• Capacity to work an 8.5-hour shift between 8 AM and 9 PM, Monday to Friday.

• Strong attention to detail.

• Professional telephone communication skills.

• Basic computer proficiency.

• Ability to effectively multitask.

• Clear and concise verbal and written communication skills.

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

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

• Bilingual skills in Spanish and English are advantageous.

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

• Willingness to travel as necessary is preferred.

• Must fulfill all work-from-home criteria; remote eligibility is contingent 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 contributions from Valeris toward premium costs.

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

• Company matching on Health Savings Account contributions.

• Complimentary Basic Life and AD&D coverage equivalent to annual earnings, ranging from a minimum of $50,000 to 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 as well as professional development.

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

• An inclusive workplace and a mission-driven culture.

• Background check and, depending on the position, drug screening as part of employment contingencies.