Patient Engagement & Care Coordinator

Valeris; Bozeman (MT); On-site; USD 38,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, vision plans

HSA- and FSA-eligible options

Company match on Health Savings

Paid Time Off

Nine paid holidays

Job summary

Valeris in the United States is seeking a healthcare customer service professional to support patients enrolled in benefits programs. You will conduct welcome calls, assist with coverage options, and guide patients through treatment and billing information.

Responsibilities include proactive outreach, de-escalation, documentation in the Lynk system, and coordination with payers and providers to optimize patient access. A compassionate, compliant approach is essential.

Qualifications

• Bachelor's degree strongly preferred or equivalent experience.
• Customer service and healthcare industry experience strongly preferred.
• Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required.
• Bi-lingual in English and Spanish or Chinese/Mandarin is a plus.

Responsibilities

• Build and maintain trusted relationships with patients by demonstrating proactive communication, delivering timely and accurate services, and showing a strong commitment to patient well-being.
• Ensure all interactions and relationship management practices comply with relevant healthcare laws and regulations.
• Demonstrate prior experience working with pharmacy benefit products and patients, or in immunology practices, to better understand patient needs and concerns.
• Conduct program welcome calls to patients, engaging them effectively and explaining available services and resources for their support.
• Utilize motivational interviewing techniques to actively involve patients in goal setting and achieving their healthcare objectives.
• Perform post Benefits Investigation calls to patients, clearly explaining coverage options to enhance patient understanding.
• Effectively handle all client inquiries that cannot be resolved through standard reporting processes.
• Address patient inquiries in accordance with applicable business rules, providing accurate and helpful information.
• Articulate complex reimbursement and billing information in a clear and concise manner to ensure patients comprehend their coverage benefits and financial responsibilities.
• Handle inbound calls as per the program-approved Frequently Asked Questions (FAQs).
• Exhibit excellent customer service skills, even in a fast-paced environment, and de-escalate any challenging situations in a professional and appropriate manner.
• Triage patients to appropriate internal or external resources, depending on their needs and requirements.
• Ensure proper documentation and recording of patient enrollment into the program, following established business rules.
• Provide patients with comprehensive information and education about products, including the course of treatment, insurance coverage benefits, anticipated out-of-pocket costs, potential financial assistance resources, and ongoing treatment support.
• Proactively manage assigned cases and tasks to maintain service levels and deliver excellent customer service to patients.
• Empower and inspire patients to take charge of their therapy plan as prescribed by their healthcare provider.
• Leverage electronic tools to identify benefits and payer coverage, conducting manual benefit investigations when necessary.
• Identify and communicate patients' plan benefit coverage, including any prior authorization, appeal, tier exception, or formulary exclusion requirements.
• Utilize electronic resources to obtain benefit coverage outcomes, and if needed, conduct outbound calls to payers and healthcare providers for follow-up.
• Support adherence services through the coordination of nurse follow-up, as applicable to the program.
• Identify and recommend peer support resources for patients to enhance their treatment experience.
• Coordinate the shipment of products through patient assistance programs and/or bridge programs from the PharmaCord pharmacy.
• Proactively communicate the need for re-verification of prior authorization or re-enrollment for patient assistance programs.
• Report adverse events, product complaints, special situation reports, and medical inquiries in accordance with established SOPs and Business Rules.
• Document all activities within the Lynk system to maintain accurate and up-to-date records, adhering to business requirements.

Skills

Customer service

Healthcare exp

Bilingual English/Spanish

Bilingual English/Chinese

Communication

Multitasking

Telephone etiquette

Empathy

Education

Bachelor's degree or equivalent

Job description

Valeris in the United States is seeking a healthcare customer service professional to support patients enrolled in benefits programs. You will conduct welcome calls, assist with coverage options, and guide patients through treatment and billing information.

Responsibilities include proactive outreach, de-escalation, documentation in the Lynk system, and coordination with payers and providers to optimize patient access. A compassionate, compliant approach is essential.