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, site-of-care centers, specialty distributors, pharmacy compounders, and healthcare providers.

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

• Act as the primary or dedicated point of contact for both internal and external stakeholders.

• Clarify benefit coordination, eligibility criteria, program enrollment, affordability assistance, and access to prescribed therapies.

• Build and nurture relationships with healthcare providers and patients.

• Gather and provide comprehensive program and patient information.

• Navigate payer obstacles and assist with prior authorization and appeals processes.

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

• Maintain records in compliance with relevant standards, regulations, program guidelines, and SOPs.

• Escalate complex cases following SOPs, Call Guides, and program documentation.

• Identify and report pharmacovigilance information, including adverse events and safety concerns.

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

• Communicate patient status updates, prescriber feedback, coordination hurdles, and program effectiveness.

• Assess situations and take necessary actions to achieve timely outcomes.

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

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

• Execute various tasks and projects assigned by Project Management.

⛳️ Requirements

• Associate or bachelor’s degree with 2 years of experience in reimbursement/insurance, healthcare billing, physician office, or health insurance processing preferred; alternatively, a High School diploma or equivalent with 5 years of relevant experience.

• Experience in Call Center/HUB or customer service roles with increasing responsibility is required.

• Exceptional oral and written communication skills.

• Strong understanding of prior authorization and appeals processes is necessary.

• Solid knowledge of medical and pharmacy insurance terminology, reimbursement/insurance, healthcare billing, and related benefit coordination.

• Excellent problem-solving and decision-making capabilities.

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

• Strong organizational skills in a dynamic work environment.

• Ability to adapt to changes while maintaining Program standards.

• Empathetic listening skills.

• Punctual, reliable, and possess a strong attendance record.

• Robust customer service experience and skills.

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

• Ability to type at least 35 words per minute with 97% accuracy is preferred.

• Flexibility to travel as required is preferred.

• 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 to premium costs.

• Telehealth and Employee Assistance Program (EAP) services.

• Company match on Health Savings Account contributions.

• Free 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 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) 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 fosters new ideas.

• An inclusive workplace and mission-driven culture.

• Minimal travel flexibility preferred.