Care Coordinator: Patient Benefits & Access

Valeris; North Carolina; On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, dental, vision plans

HSA/FSA options

401(k) matching

Paid Time Off

Paid holidays

Job summary

Valeris is a fully integrated life sciences commercialization partner focused on patient access and support. The Care Coordinator role involves inbound/outbound calls to payers, patients, and providers to coordinate benefits, orders, and appointments, ensuring a smooth patient journey supported by the Patient Support Program for manufacturers.

You will act as a primary contact and advocate, handling benefit coordination and access questions, and liaising with program management and healthcare

Qualifications

• Associate or bachelor’s degree and 2 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing preferred, or in lieu of a degree, a High School diploma or equivalent with 5 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing
• Call Center/HUB or customer service experience with progressive levels of responsibility within a service driven environment required
• Excellent communication skills; orally and in writing
• Strong working knowledge of prior authorization and appeals is required
• Strong 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 required
• Attention to detail and committed follow through in communication with patients, providers, and internal/external stakeholders
• Strong organizational skills for fast paced environment
• Ability to adapt to change while maintaining Program standards
• Strong team players are willing to jump in and help other team members when needed.
• Empathetic listening skills to interact effectively with patients and providers
• Punctual, reliable with strong attendance record
• Strong customer service experience and skills

Responsibilities

• Serve as expert on all aspects of benefit coordination and handle healthcare provider and/or patient interactions
• Advocate for eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy
• Establish relationships and maintain rapport with healthcare providers and/or patients
• Serve as point of contact to health care providers for ongoing support and relationship development
• Understand benefits offered by private/commercial and government payers (Medicare/Medicaid/VA/DOD)
• Navigate payer challenges by asking questions to obtain the necessary result
• Act as liaison to client contacts (e.g., regional sales reps)
• Maintain records in accordance with applicable standards and regulations to the programs/promotion
• Follow program guidelines and escalate complex cases per SOPs
• Identify and report pharmacovigilance information as required by client(s) via inbound/outbound calls
• Liaison between Program Management and healthcare providers
• Provide unparalleled customer service and represent the brand; ensure quality outcomes
• Maintain open communication with Program Management on patient status and feedback
• Understand disease states of patients in the program
• Assess situations to intervene for timely results
• Maintain confidentiality and privacy
• Support team morale with positive attitude and work ethics
• Utilize resources for conflict resolution as needed
• Meet training deadlines and ensure SOP adherence
• Perform additional tasks or projects as assigned

Skills

Customer service

Excellent communication

Prior auth & appeals

Medical & pharmacy terminology

Problem-solving & decision-making

Attention to detail

Organizational skills

Empathetic listening

Punctual & reliable attendance

Education

Associate or bachelor’s degree

High School diploma with 5 years experience

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Outlook

Job description

Valeris is a fully integrated life sciences commercialization partner focused on patient access and support. The Care Coordinator role involves inbound/outbound calls to payers, patients, and providers to coordinate benefits, orders, and appointments, ensuring a smooth patient journey supported by the Patient Support Program for manufacturers.

You will act as a primary contact and advocate, handling benefit coordination and access questions, and liaising with program management and healthcare