Care Coordinator

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

📋 Description

• Take ownership of patient cases from beginning to end

• Conduct benefit investigations and manage prior authorizations as well as denial appeals

• Assess financial eligibility for assistance programs

• Support patients, prescribers, and stakeholders in resolving issues via email, inbound/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

• Address inquiries from clients and healthcare providers

• Handle incoming calls and direct patients to the appropriate resources

• Deliver personalized case management and relay information about benefit coverage and next steps

• Identify requirements for prior authorization, appeals, tier exceptions, and formulary exclusions

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

• Coordinate nurse education, adherence services, peer support, and product shipments

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

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

• Log activities in the PharmaCord Lynk system

• Complete necessary training and adhere to SOPs

• Undertake additional assigned tasks or projects

⛳️ Requirements

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

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

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

• Bilingual skills in Spanish and English are advantageous

• Eligibility for remote work is subject to work-from-home criteria and business requirements

• Attention to detail is essential

• Professional telephone manner is necessary

• Basic computer skills are required

• Ability to effectively multitask

• Clear and concise communication skills are a must

• Typing speed of at least 35 words per minute with 97% accuracy is preferred

• Successful completion of a background check and, depending on the role, 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 equivalent 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 with 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 promotes innovative ideas

• An inclusive workplace and a mission-driven culture

• Preference for minimal travel flexibility