Care Coordinator - Patient Access & Benefits

Valeris; Raleigh (NC); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, and vision plans with

HSA- and FSA-eligible options

401(k) match

Life and AD&D coverage

Short-Term Disability

PTO and Sick Leave

Paid holidays

Career advancement

Inclusive culture

Job summary

Valeris is seeking a Care Coordinator to provide inbound and outbound phone support and coordinate patient benefits, orders, and appointment scheduling across the patient journey.

You will serve as a primary contact for payers, patients, caregivers, and providers, coordinating resources and ensuring timely delivery of services while maintaining confidentiality and a high level of service.

Qualifications

• Associate or bachelor’s degree plus 2 years reimbursement/insurance experience; or a HS diploma with 5 years in reimbursement/insurance.
• Call Center/HUB or customer service experience with rising responsibility in a service-driven environment.
• Excellent communication skills, both oral and written.
• Strong knowledge of prior authorization and appeals processes.
• Strong medical and pharmacy insurance terminology and reimbursement/insurance experience.
• Proficient with Microsoft Office suite (Excel, Word, PowerPoint, Outlook).

Responsibilities

• Care Coordinator may be regionally aligned and serve as an expert on benefit coordination and provider interactions.
• Advocate for patients regarding eligibility, enrollment, and affordability support.
• Build and maintain relationships with healthcare providers and patients.
• Serve as point of contact to health care providers for ongoing support and information.
• Explain benefits across payer types including Medicare, Medicaid, VA and DOD.
• Escalate complex cases per SOPs and call guides; report pharmacovigilance information when required.
• Act as liaison to client contacts and internal stakeholders; ensure timely patient status updates.
• Maintain records in compliance with program standards and regulations.

Skills

Call Center experience

Customer service

Excellent communication

Prior authorization knowledge

Medical/pharmacy terminology

Problem solving

Attention to detail

Organization

Empathetic listening

Team player

Education

Associate or Bachelor’s degree + 2 years reimbursement/insurance

High School diploma + 5 years reimbursement/insurance (in lieu of degree)

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Outlook

Job description

Valeris is seeking a Care Coordinator to provide inbound and outbound phone support and coordinate patient benefits, orders, and appointment scheduling across the patient journey.

You will serve as a primary contact for payers, patients, caregivers, and providers, coordinating resources and ensuring timely delivery of services while maintaining confidentiality and a high level of service.