Care Coordinator

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

📋 Description

• Take ownership of patient cases from start to finish

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

• Assess financial qualifications for assistance programs

• Support patients and stakeholders through resolution via email, inbound and outbound calls, and Lynk technology

• Foster trusted relationships with patients, prescribers, and client stakeholders

• Conduct program welcome calls and follow-up calls after benefit investigations

• Address inquiries from clients and healthcare providers

• Handle inbound calls and direct patients to appropriate resources

• Deliver personalized case management to patients and healthcare providers

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

• Relay information regarding benefit coverage, prior authorization, appeals, tier exceptions, and formulary exclusions

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

• Coordinate nursing education, follow-up, and adherence services as applicable

• Identify resources for peer support

• Organize 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 in accordance with SOPs and business rules

• Document activities in the PharmaCord Lynk system

• Adhere to corporate policies, SOPs, and training deadlines

• Undertake additional assigned tasks or projects

⛳️ Requirements

• Strong attention to detail

• Professional telephone communication skills

• Fundamental computer proficiency

• Capacity to multitask efficiently

• Commitment to honesty and integrity, taking responsibility for performance

• Flexibility to adapt to changes

• Clear and effective communication skills

• Bachelor’s degree preferred or equivalent experience required

• Customer service and healthcare industry experience is preferred but not mandatory

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

• Proficiency in typing at least 35 words per minute with 97% accuracy preferred

• Willingness to travel as needed is preferred

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

• Bilingual skills in Spanish and English are an asset

🏝️ Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with contributions from Valeris towards premium costs

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

• Company match on 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-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 plus two floating holidays

• Opportunities for advancement and personal and professional development

• A challenging and stimulating work environment that encourages new ideas

• An inclusive workplace with a mission-driven culture

• Remote work eligibility based on work-from-home criteria and business needs