Care Coordinator

TEKsystems • Durham, NC

11d • $22 - $26 • Remote

About The Position

As a Care Coordinator, you provide inbound and outbound phone support and may serve as the primary contact for payers, patients, caregivers, specialty pharmacies, site of care centers, specialty distributors, pharmacy compounders, and providers. You facilitate a collaborative process to gauge, coordinate, and monitor patient benefits, product orders, and appointment coordination, helping support the overall patient journey through a manufacturer’s Patient Support Program.

The primary function is to provide customer service to internal and external stakeholders as a dedicated contact by coordinating resources, exchanging information, and ensuring appropriate delivery of services. The role may be regionally aligned and serves as an expert on benefit coordination and other available support. This is a contract position based remotely, with a stated location in Morrisville, North Carolina. The posted pay range is $22.00–$26.00 per hour.

Requirements

• Call center or customer service experience with progressive responsibility in a service-driven environment.
• Excellent oral and written communication skills.
• Strong working knowledge of prior authorization and appeals.
• Strong knowledge of medical and pharmacy insurance terminology and reimbursement, insurance, healthcare billing, physician office, health insurance processing, or related benefit coordination.
• Proficiency with Microsoft products.
• Computer experience and internet bandwidth sufficient to support Valeris systems.
• Experience using CRM software, multi-line telephones, and multiple computer systems or applications at the same time.
• Ability to communicate by telephone and/or email with patients and physicians’ offices.
• Associate or bachelor’s degree and two years of reimbursement/insurance, healthcare billing, physician office, or health insurance processing experience; alternatively, a high school diploma or equivalent and five years of such experience.
• Ability to meet role expectations for productivity, professional development, feedback, teamwork, and adaptability.

Nice To Haves

• Previous HUB or Patient Services experience.
• Contact center experience.
• More than two years of pharmaceutical benefit processes experience.
• More than two years of medical benefit processes experience.

Responsibilities

• Provide inbound and outbound phone support and coordinate resources, information, and services for patients and stakeholders.
• Serve as a contact for payers, patients, caregivers, specialty pharmacies, sites of care, specialty distributors, pharmacy compounders, healthcare providers, and client contacts.
• Coordinate and monitor patient benefits, product orders, and appointments to support the patient journey.
• Explain benefit coordination and available support, including payer benefits and patient eligibility, program enrollment, affordability support, and access to prescribed therapy.
• Build and maintain relationships and trust with patients and healthcare providers; provide ongoing program information and support.
• Navigate payer challenges by asking appropriate questions to obtain needed outcomes.
• Maintain records in accordance with applicable program standards and regulations.
• Follow program guidelines, SOPs, call guides, and other program materials; escalate complex cases as appropriate.
• Identify and report pharmacovigilance information, including adverse events and safety complaints, as required by client and program procedures.
• Coordinate between Program Management, internal stakeholders, and healthcare providers; communicate patient status, prescriber feedback, coordination challenges, and program effectiveness.
• Provide attentive customer service as a brand advocate and program representative while pursuing quality outcomes and appropriate resource use.
• Understand relevant patient disease states and assess situations to intervene when needed to achieve timely results.
• Maintain ethical and professional conduct regarding confidentiality and privacy.
• Meet training deadlines for corporate policies and procedures, and follow SOPs consistently.
• Support team morale and success, demonstrate a positive attitude and strong work ethic, adapt to change, and use appropriate resources for conflict resolution.
• Complete additional tasks and projects as assigned by Project Management.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Critical illness, accident, and hospital coverage
• 401(k) retirement plan with pre-tax and Roth post-tax contributions
• Life insurance, including voluntary life and AD&D coverage for employees and dependents
• Short- and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time off or leave, which may include PTO, vacation, or sick leave

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree