Care Coordinator

Valeris • Remote, North Carolina, NC

6d

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 appointments, supporting the overall patient journey through services offered by a manufacturer’s Patient Support Program. The primary function is to provide customer service to internal and external stakeholders by coordinating resources, exchanging information, and ensuring appropriate service delivery.

The role may be regionally aligned and serves as an expert on benefit coordination and available support. The Care Coordinator handles healthcare provider and/or patient interactions, follows program guidelines and procedures, and works with Program Management and other stakeholders to support patients and providers. The position operates in a professional office environment and routinely uses standard office equipment. Minimal travel may be needed.

Requirements

• Associate or bachelor’s degree and 2 years of reimbursement/insurance, healthcare billing, physician office, or health insurance processing experience; alternatively, a high school diploma or equivalent and 5 years of such experience.
• Call center, HUB, 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.
• Knowledge of medical and pharmacy insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing, or related benefit coordination experience.
• Excellent problem-solving and decision-making skills.
• Attention to detail and reliable follow-through in communication with patients, providers, and internal and external stakeholders.
• Strong organizational skills for a fast-paced environment.
• Ability to adapt to change while maintaining program standards.
• Team-oriented approach and willingness to help other team members.
• Empathetic listening skills for effective interaction with patients and providers.
• Punctuality, reliability, and a strong attendance record.
• Strong customer service skills and experience.
• Proficiency with Microsoft Excel, Word, PowerPoint, and Outlook.

Nice To Haves

• Ability to type at least 35 words per minute with 97% accuracy.
• Flexibility to travel as needed, though travel is described as very minimal.

Responsibilities

• Provide inbound and outbound phone support to patients, caregivers, healthcare providers, payers, pharmacies, distributors, and other program stakeholders.
• Coordinate patient benefits, product orders, and appointments to facilitate the patient journey.
• Advocate for patients regarding eligibility requirements, program enrollment, affordability support, and access to prescribed therapy.
• Build relationships and maintain trust and rapport with healthcare providers and patients.
• Serve as a point of contact for healthcare providers, providing detailed information about programs and patients’ ongoing support needs.
• Explain benefits offered by private/commercial and government payers, including Medicare, Medicaid, VA, and DOD, with expertise in Medicare Part B.
• Navigate payer challenges by asking appropriate questions to obtain necessary results.
• Act as an assigned liaison to client contacts, such as regional sales representatives.
• Maintain records in accordance with applicable program standards and regulations.
• Follow program guidelines, SOPs, call guides, and other program materials, and escalate complex cases as appropriate.
• Identify and report pharmacovigilance information, including adverse events and safety complaints, as required by client and program procedures.
• Liaise between Program Management, other internal stakeholders, and healthcare providers.
• Deliver customer service with attention to detail while representing the brand and program and using resources appropriately to achieve quality outcomes.
• Communicate regularly with Program Management about patient status, prescriber feedback and satisfaction, coordination challenges, and program effectiveness.
• Understand the disease states relevant to patients in the program and intervene as needed to obtain timely results.
• Maintain ethical and professional conduct regarding confidentiality and privacy.
• Support team morale through a positive attitude and strong work ethic, and use appropriate resources for conflict resolution.
• Complete training on time and consistently follow corporate policies, procedures, and SOPs.
• Complete additional tasks or projects as assigned by Project Management.
• Use Valeris’ values to support the team’s success.

Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs.
• Telehealth and Employee Assistance Program (EAP) services.
• Company match on Health Savings Account contributions.
• Free 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 with 100% match on the first 5% contributed and immediate vesting.
• Paid Time Off (PTO) and Sick Leave.
• Nine paid holidays and two floating holidays.
• Opportunities for advancement and personal and professional growth.
• A challenging, stimulating work environment that encourages new ideas.
• An inclusive workplace and mission-driven culture.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree