Executive Care Coordinator, Bilingual

🔥 0 minutes ago

🌵 Arizona, North Carolina – Remote

🌵 Arizona – Remote 🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

💬 Bilingual

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Valeris

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💊 Pharmaceuticals

🏥 Healthcare

🤝 B2B

Pharmaceuticals • Healthcare • B2B

Valeris is a fully integrated life sciences commercialization partner formed by the merger of PharmaCord and Mercalis. The company provides comprehensive solutions across the healthcare value chain to help life sciences companies bring products to market and improve patient access and adherence. Valeris offers data and strategic insights, patient support and access programs, and healthcare provider engagement tools, serving over 500 life sciences customers and supporting millions of patients. Headquartered in Morrisville, North Carolina and Jeffersonville, Indiana, Valeris focuses on enabling commercialization and patient-centric services for pharmaceutical and life sciences organizations.

📋 Description

• Deliver an exceptional patient experience while helping patients navigate access to complex medications • Manage each patient journey from initiation to closure • Complete benefit investigations and track prior authorizations and denial appeals • Assist patients, callers, healthcare providers, caregivers, specialty pharmacies, and stakeholders through resolution via email, inbound/outbound calls, and Lynk technology • Explain coverage options, next steps, benefits, and program eligibility • Educate healthcare provider offices on payer processes and procedures • Build and manage trusted relationships with patients, prescribers, and client stakeholders • Triage patients to internal or external resources as appropriate • Provide personalized case management and communicate benefit coverage and access next steps • Identify prior authorization, appeal, tier exception, and formulary exclusion requirements • Follow up with payers and healthcare providers on submissions and outcomes • Coordinate nurse teaching with nurse educators and support adherence services as applicable • Identify peer support resources and proactively communicate reverification or re-enrollment needs • Identify and report adverse events, product complaints, special situation reports, and medical inquiries • Document reimbursement activities in Lynk, including claims status, payments, and appeals • Generate reports and analyses to identify trends and improvement opportunities • Follow corporate policies, SOPs, program rules, and training deadlines • Perform additional assigned tasks or projects

🎯 Requirements

• Fluent in both Spanish and English • Bachelor's degree or higher required • Degree in healthcare administration, social science, or a related field strongly preferred • In lieu of a degree, five plus years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education required • Two years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education required • Minimum two years of experience in healthcare access delivery or management strongly preferred • Other certifications and five or more consecutive years of relevant experience will be considered • Knowledge of medical terminology and coding systems, including ICD-10, CPT, and HCPCS • Strong understanding of insurance processes • Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines • Excellent attention to detail and organizational skills • Ability to prioritize tasks and work efficiently in a fast-paced environment • Effective written and verbal communication and interpersonal skills • Ability to think critically and resolve issues • Ability to type at least 35 words per minute with 97% accuracy preferred • Remote work eligibility subject to work-from-home criteria and business need • Successful completion of a background check and, depending on the position, a drug screen

🏖️ 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 your 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% you contribute, with immediate vesting • Paid Time Off (PTO) and Sick Leave • Nine paid holidays plus two floating holidays • Opportunities for advancement and personal and professional growth • Challenging, stimulating work environment that encourages new ideas • Inclusive workplace and mission-driven culture • Minimal travel as needed preferred