Executive Care Coordinator

🔥 0 minutes ago

🐎 Kentucky – Remote

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⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Executive

👻 Ghost score 10%

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Valeris

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

• Manage the patient journey from initiation to closure • Complete benefit investigations and track prior authorizations and denial appeals • Assist patients, caregivers, healthcare providers, specialty pharmacies, and other stakeholders through resolution via email, inbound/outbound calls, and Lynk technology • Explain coverage options and next steps after benefits investigations • Manage client and healthcare-provider inquiries • Build trusted relationships through proactive, timely, and accurate communication • Triage patients to internal or external resources as appropriate • Provide personalized case management and communicate benefit coverage and next steps • Identify prior authorization, appeal, tier exception, and formulary exclusion requirements • Contact payers and healthcare providers to follow up on submissions and outcomes • Coordinate nurse teaching with nurse educators and support adherence services • Identify peer-support resources and communicate reverification or re-enrollment needs • Identify and report adverse events, product complaints, special situation reports, and medical inquiries • Document reimbursement activities, claims status, payments, and appeals in Lynk • Generate reports and analysis to identify trends and improvement opportunities • Serve as a subject matter expert to the internal team • Follow SOPs, corporate policies, training deadlines, and program operating procedures • Perform additional tasks or projects as assigned

🎯 Requirements

• Completion of Bachelor's degree (or higher) required; degree in healthcare administration, social science or similar related fields strongly preferred • In lieu of a degree, five plus years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education is 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 experience in a relevant field may be considered; examples include PACS, CHES, or CCM • Strong understanding of medical terminology and coding systems (ICD-10, CPT, HCPCS) • Knowledge of insurance processes, HIPAA, and Medicare/Medicaid guidelines • Ability to meet work-from-home criteria, subject to business need • Ability to type at least 35 words per minute with 97% accuracy preferred • 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 • Critical-thinking and issue-resolution abilities • Bilingual skills are a plus • Successful completion of a background check and, depending on 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 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, 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 • Flexibility to travel as needed is preferred

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