Care Coordinator

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

📋 Description

• Deliver both inbound and outbound telephone support to payers, patients, caregivers, specialty pharmacies, distributors, providers, and various stakeholders.

• Manage patient benefits, product orders, appointments, and the overall patient experience.

• Leverage Patient Support Program services on behalf of life sciences manufacturers.

• Act as a primary point of contact by coordinating resources, sharing information, and ensuring effective service delivery.

• Provide guidance on benefit coordination and available support options.

• Advocate for patients concerning eligibility, enrollment, affordability support, and access to therapy.

• Build and sustain relationships with healthcare providers and patients.

• Gather and present comprehensive program and patient information.

• Clarify payer benefits, encompassing private/commercial and government programs like Medicare, Medicaid, VA, and DOD, with a focus on Medicare Part B.

• Navigate payer challenges to achieve favorable outcomes.

• Collaborate with client contacts, Program Management, internal stakeholders, and healthcare providers.

• Keep records in compliance with applicable standards, regulations, and program requirements.

• Adhere to program guidelines, SOPs, Call Guides, and other program materials; escalate complex cases as necessary.

• Identify and report pharmacovigilance data, adverse events, and safety concerns as needed.

• Offer customer service as a brand advocate and program representative.

• Track and communicate patient status, prescriber feedback, coordination challenges, and program effectiveness.

• Understand relevant patient disease states and act to secure timely results.

• Uphold confidentiality, privacy, ethical conduct, and professional standards.

• Assist in conflict resolution and foster team morale.

• Complete mandatory training and adhere to corporate policies and procedures.

• Undertake additional miscellaneous tasks or projects as assigned by Project Management.

⛳️ Requirements

• Prior experience in CLS is mandatory.

• An associate or bachelor’s degree with 2 years of experience in reimbursement/insurance, healthcare billing, physician office, or health insurance processing is preferred; alternatively, a high school diploma or equivalent with 5 years of relevant experience may be considered.

• Required experience in Call Center/HUB or customer service with progressive responsibilities.

• Exceptional oral and written communication abilities.

• Strong familiarity with prior authorization and appeals processes is essential.

• Comprehensive knowledge of medical and pharmacy insurance terminology along with reimbursement/insurance, healthcare billing, physician office, health insurance processing, or related benefit coordination.

• Excellent problem-solving and decision-making capabilities.

• Strong attention to detail and commitment to follow-through.

• Effective organizational skills in a dynamic environment.

• Capacity to adapt to changes while maintaining program standards.

• Team-oriented attitude and readiness to support colleagues.

• Proficient empathetic listening skills.

• Dependable punctuality, reliability, and an excellent attendance record.

• Strong background in customer service and skills.

• Proficiency in Microsoft Excel, Word, PowerPoint, and Outlook.

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

• Willingness to travel as necessary is preferred.

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

🏝️ Benefits

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

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

• Company matching contributions to Health Savings Accounts.

• Complimentary Basic Life and AD&D coverage equivalent to annual earnings, 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 featuring a 100% match on the first 5% contributed, with immediate vesting.

• Paid Time Off (PTO) along with Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for career advancement and both personal and professional development.

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

• An inclusive workplace with a mission-driven culture.

• Background check and, depending on the position, drug screening aligned with company standards.