Care Coordinator
Mercalis, Morrisville, NC, United States
Overview
*** THE SHIFT FOR THIS ROLE IS M-F 10A-7P EST ONLY***
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.
As a Care Coordinator, you provide inbound and outbound phone support and may serve as the primary contact for payers, patients, caregivers, specialty pharmacies, site of care centers, specialty distributors, pharmacy compounders, and providers. You will facilitate a collaborative process that gauges, coordinates, and monitors patient benefits, product orders and appointment coordination with the purpose of facilitating the overall patient journey. This includes utilizing services offered through the Patient Support Program on behalf of a manufacturer (client). The primary function is to provide unparalleled customer service to key internal and external stakeholders as a dedicated contact by coordinating resources, exchanging information, and ensuring appropriate
Responsibilities
Care Coordinator may be regionally aligned and will serve as an expert on all aspects of benefit coordination, and other forms of available support and will be responsible for handling healthcare provider and/or patient interactions
May serve as an advocate to patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy
Establishes relationships, develop trust, and maintain rapport with healthcare providers and/or patients
Serves as point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
Strong working knowledge and ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B
Navigates through payer challenges by asking appropriate questions to obtain the necessary result
Acts as an assigned liaison to client contacts (e.g., regional contact for sales representatives)
Maintains records in accordance with applicable standards and regulations to the programs/promotion
Follows program guidelines and escalates complex cases according to SOPs, Call Guides, and other program materials.
Liaison between Program Management, other internal stakeholders, and healthcare providers
Provides unparalleled customer service, with attention to detail, while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commits to the appropriate use of resources
Works with all levels of Program Management on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction, coordination challenges and program effectiveness
Understands the nature of the disease states of patients of the program
Assesses situations to act and intervene where needed to obtain a timely result
Maintains a high level of ethical and professional conduct regarding confidentiality and privacy
Helps maintain team morale by consistently demonstrating a positive attitude and strong work ethics
Utilizes the necessary resources for conflict resolution as needed.
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
Proficient with Microsoft products (Excel, Word, PowerPoint, and Outlook)
Physical Demands & Work Environment
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We’re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
Additional health support, including 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 to support work-life balance
Team members receive nine paid holidays plus two floating holidays
Opportunities for advancement in a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
A mission-driven, inclusive culture where your work makes a meaningful impact
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.
Our Commitment to Equal Opportunity
At Valeris, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
*** THE SHIFT FOR THIS ROLE IS M-F 10A-7P EST ONLY***
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.
As a Care Coordinator, you provide inbound and outbound phone support and may serve as the primary contact for payers, patients, caregivers, specialty pharmacies, site of care centers, specialty distributors, pharmacy compounders, and providers. You will facilitate a collaborative process that gauges, coordinates, and monitors patient benefits, product orders and appointment coordination with the purpose of facilitating the overall patient journey. This includes utilizing services offered through the Patient Support Program on behalf of a manufacturer (client). The primary function is to provide unparalleled customer service to key internal and external stakeholders as a dedicated contact by coordinating resources, exchanging information, and ensuring appropriate
Responsibilities
Care Coordinator may be regionally aligned and will serve as an expert on all aspects of benefit coordination, and other forms of available support and will be responsible for handling healthcare provider and/or patient interactions
May serve as an advocate to patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy
Establishes relationships, develop trust, and maintain rapport with healthcare providers and/or patients
Serves as point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
Strong working knowledge and ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B
Navigates through payer challenges by asking appropriate questions to obtain the necessary result
Acts as an assigned liaison to client contacts (e.g., regional contact for sales representatives)
Maintains records in accordance with applicable standards and regulations to the programs/promotion
Follows program guidelines and escalates complex cases according to SOPs, Call Guides, and other program materials.
Liaison between Program Management, other internal stakeholders, and healthcare providers
Provides unparalleled customer service, with attention to detail, while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commits to the appropriate use of resources
Works with all levels of Program Management on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction, coordination challenges and program effectiveness
Understands the nature of the disease states of patients of the program
Assesses situations to act and intervene where needed to obtain a timely result
Maintains a high level of ethical and professional conduct regarding confidentiality and privacy
Helps maintain team morale by consistently demonstrating a positive attitude and strong work ethics
Utilizes the necessary resources for conflict resolution as needed.
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
Proficient with Microsoft products (Excel, Word, PowerPoint, and Outlook)
Physical Demands & Work Environment
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We’re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
Additional health support, including 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 to support work-life balance
Team members receive nine paid holidays plus two floating holidays
Opportunities for advancement in a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
A mission-driven, inclusive culture where your work makes a meaningful impact
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.
Our Commitment to Equal Opportunity
At Valeris, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.