Care Coordinator

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

📋 Description

• Deliver inbound and outbound telephonic support to payers, patients, caregivers, specialty pharmacies, care centers, specialty distributors, pharmacy compounders, and healthcare providers.

• Coordinate and oversee patient benefits, product orders, and appointment scheduling to enhance the patient experience.

• Act as a specialist in benefit coordination and available support services.

• Advocate for patients concerning their eligibility, program enrollment, affordability assistance, and access to prescribed therapies.

• Build and sustain relationships with healthcare providers and patients.

• Provide ongoing program and patient updates to healthcare professionals.

• Address payer challenges and secure necessary outcomes.

• Serve as a liaison among client contacts, Program Management, internal teams, and healthcare providers.

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

• Adhere to SOPs, Call Guides, and program documentation; escalate intricate cases as needed.

• Identify and report pharmacovigilance information, including adverse events and safety complaints, as necessary.

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

• Communicate patient status, prescriber feedback, coordination hurdles, and program effectiveness to Program Management.

• Understand patient disease states and evaluate situations to achieve timely results.

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

• Complete all required training and adhere to corporate policies and SOPs.

• Undertake miscellaneous tasks and projects as assigned by Project Management.

⛳️ Requirements

• 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 along with 5 years of experience in reimbursement/insurance, healthcare billing, physician office, or health insurance processing is required.

• Experience in Call Center/HUB or customer service with progressive responsibilities in a service-oriented environment is mandatory.

• Exceptional oral and written communication skills are essential.

• Strong working knowledge of prior authorization and appeals processes is required.

• Comprehensive understanding of medical and pharmacy insurance terminology is necessary.

• Experience in reimbursement/insurance, healthcare billing, physician office, health insurance processing, or related benefit coordination is vital.

• Excellent problem-solving and decision-making abilities are crucial.

• Attention to detail and strong commitment to follow-through are required.

• Solid organizational skills in a fast-paced setting are important.

• Ability to adapt to changes while upholding program standards is essential.

• A team-oriented mindset and willingness to support colleagues are necessary.

• Empathetic listening skills for effective interactions with patients and providers are crucial.

• Punctuality, reliability, and a strong attendance record are expected.

• Proven customer service experience and skills are required.

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

• Candidates should ideally be able to 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 role, a drug screen is required.

🏝️ 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 matching 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 along with two floating holidays.

• Opportunities for career advancement and personal as well as professional development.

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

• An inclusive workplace and mission-driven culture.

• Background check and, depending on the position, drug screen required as a condition of employment.