Care Coordinator

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

📋 Description

• Take ownership of patient cases from start to finish.

• Carry out benefit investigations and manage prior authorizations and denial appeals.

• Assess financial eligibility for assistance programs.

• Support patients, callers, and stakeholders through resolution using 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.

• Clarify coverage options for patients and healthcare professionals.

• Manage client and healthcare provider inquiries in accordance with reporting requirements and business protocols.

• Handle incoming calls using program-approved FAQs.

• Direct patients to internal or external resources as needed.

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

• Utilize electronic tools and manual investigations to identify benefits and payer coverage.

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

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

• Coordinate nurse education and follow-up services.

• Identify available peer support resources.

• Manage product shipments through patient assistance and bridge programs.

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

• Report adverse events, product complaints, special situation reports, and medical inquiries per SOPs and business protocols.

• Document all activities in the PharmaCord Lynk system.

• Adhere to corporate policies, SOPs, training deadlines, and business requirements.

• Undertake additional assigned tasks and projects.

⛳️ Requirements

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

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

• Ability to work an 8.5-hour shift between 8 am and 9 pm, Monday to Friday is required.

• A shift from 11:30 AM to 8 PM ET is required.

• Strong communication skills, both clear and concise.

• Attention to detail is essential.

• Professional telephone etiquette is required.

• Basic computer skills are necessary.

• Ability to multitask efficiently.

• Adaptability and flexibility in response to change are important.

• Typing skills of at least 35 words per minute with 97% accuracy are preferred.

• Willingness to travel as needed is preferred.

• Successful completion of a background check and, depending on the position, a drug screen is required.

• Bilingual skills in Spanish and English are a plus.

🏝️ 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 equal to annual earnings, with a minimum of $50,000 and a maximum of $300,000.

• Company-funded Short-Term Disability coverage, with the 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 and professional development.

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

• Commitment to diversity and inclusive workplace initiatives.

• A mission-driven and inclusive culture.

• Eligibility for remote work based on work-from-home criteria and business needs.