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, obtain prior authorizations, manage denial appeals, and assess financial qualifications for assistance programs.

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

• Establish trusted relationships with patients, prescribers, and client stakeholders.

• Execute program welcome calls and follow-up calls after benefit investigations.

• Clarify coverage options to both patients and physicians.

• Handle client and healthcare provider inquiries in accordance with business rules.

• Manage incoming calls and direct patients to appropriate resources.

• Deliver personalized case management while communicating benefit coverage and next steps.

• Identify benefits and payer coverage using electronic tools and manual research.

• Relay prior authorization, appeal, tier exception, and formulary exclusion requirements.

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

• Coordinate nurse education and follow-up services.

• Identify peer support resources.

• Arrange product shipments through patient assistance and bridge programs.

• Oversee prior authorization reverification and patient assistance program reenrollment requirements.

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

• Document all activities within the PharmaCord Lynk system.

• Meet training deadlines and adhere to SOPs.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

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

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

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

• Bilingual skills in Spanish and English are advantageous.

• Eligibility for remote work is contingent upon meeting all work-from-home criteria and business needs.

• Attention to detail is essential.

• Professional telephone etiquette is required.

• Basic computer skills are necessary.

• Ability to multitask effectively is important.

• Clear and concise communication skills are a must.

• Candidates who can type at least 35 words per minute with 97% accuracy are preferred.

• Flexibility to travel as needed is preferred.

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

🏝️ Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing to premium costs.

• Telehealth services and Employee Assistance Program (EAP) offerings.

• 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 benefits.

• Nine paid holidays along with two floating holidays.

• Opportunities for career advancement and personal professional development.

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

• An inclusive workplace with a mission-driven culture.

• Some travel flexibility preferred.