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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient case management, including benefit investigations, prior authorizations, and effective communication with patients and healthcare providers. Proficient in utilizing electronic tools for identifying benefits and payer coverage while adhering to corporate policies and SOPs.
Highest-signal resume keywords
Patient Case ManagementBenefit InvestigationsPrior AuthorizationsClear CommunicationCustomer Service
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Benefit InvestigationsPrior AuthorizationsCase ManagementTyping (35 WPM, 97% Accuracy)Financial Qualifications Assessment
Soft Skills
Detail OrientedProfessional Telephone EtiquetteMultitaskingAdaptabilityHonesty and Integrity
Tools & Technologies
PharmaCord Lynk SystemElectronic Tools for Benefit Identification
Industry Keywords
Healthcare Industry ExperiencePatient Assistance ProgramsStakeholder CommunicationSOP ComplianceBilingual (Spanish and English)
About the role
Key responsibilities & impact- Own patient cases from initiation to closure
- Perform benefit investigations and prior authorizations/denial appeals
- Determine financial qualifications for assistance programs
- Assist patients and callers/stakeholders through resolution via email, inbound/outbound calls, and Lynk technology
- Build trusted relationships with patients, prescribers, and client stakeholders
- Perform program welcome calls and post-benefit-investigation calls
- Manage client and healthcare provider inquiries
- Manage inbound calls and triage patients to appropriate resources
- Provide personalized case management to patients and healthcare providers
- Identify benefits and payer coverage using electronic tools and manual investigations
- Communicate benefit coverage, prior authorization, appeal, tier exception, and formulary-exclusion information
- Follow up with payers and healthcare providers on submissions and outcomes
- Coordinate nurse teaching, nurse follow-up, and adherence services as applicable
- Identify peer support resources
- Coordinate product shipments through patient assistance and bridge programs
- Communicate prior-authorization reverification and patient-assistance re-enrollment needs
- Report adverse events, product complaints, special situation reports, and medical inquiries according to SOPs and business rules
- Document activities in the PharmaCord Lynk system
- Follow corporate policies, SOPs, and training deadlines
- Perform additional assigned tasks or projects
Requirements
What you’ll need- Detail oriented
- Professional telephone etiquette
- Basic computer knowledge
- Ability to multitask effectively
- Ability to maintain honesty and integrity and take responsibility for performance
- Ability to adapt to change and remain flexible
- Clear and concise communication
- Bachelor’s degree strongly preferred or equivalent experience required
- Customer service and healthcare industry experience preferred but not required
- Ability to work an 8.5-hour shift between 8 am and 9 pm, Monday to Friday required
- Ability to type at least 35 words per minute with 97% accuracy preferred
- Flexibility to travel as needed preferred
- Successful completion of a background check and, depending on position, a drug screen
- Bilingual Spanish and English skills are a plus
Benefits
Comp & perks- 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 encouraging new ideas
- Inclusive workplace and mission-driven culture
- Remote work eligibility subject to work-from-home criteria and business need