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About the role
Key responsibilities & impact- Build and maintain trusted relationships with patients through proactive communication and timely, accurate services
- Ensure interactions comply with relevant healthcare laws and regulations
- Conduct program welcome calls and explain available services and resources
- Use motivational interviewing techniques to support patient goal setting
- Conduct post-Benefits Investigation calls and explain coverage options
- Handle client and patient inquiries according to business rules and approved FAQs
- Explain reimbursement, billing, coverage benefits, financial responsibilities, and assistance resources
- De-escalate challenging situations and triage patients to appropriate resources
- Document patient enrollment and all activities in the Lynk system
- Provide education about products, treatment, insurance benefits, out-of-pocket costs, and treatment support
- Manage assigned cases and tasks to maintain service levels
- Support patients in following prescribed therapy plans
- Identify benefits and payer coverage through electronic tools and manual investigations
- Communicate prior authorization, appeal, tier exception, and formulary exclusion requirements
- Contact payers and healthcare providers for benefit follow-up
- Coordinate nurse follow-up and adherence services
- Recommend peer support resources
- Coordinate product shipments through patient assistance and bridge programs from the PharmaCord pharmacy
- Manage prior authorization re-verification and patient assistance re-enrollment
- Report adverse events, product complaints, special situation reports, and medical inquiries per SOPs and Business Rules
Requirements
What you’ll need- Bachelor's degree strongly preferred or equivalent experience required; high school diploma or GED required
- 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
- Commitment to the mission of care coordination
- Passionate, trustworthy, and empathetic when working with patients
- Good communication and interpersonal skills; ability to speak concisely to patients
- Flexible and adaptable to changing patient and healthcare providers’ needs
- Professional telephone etiquette
- Basic computer knowledge
- Ability to multitask effectively
- Ability to type at least 35 words per minute with 97% accuracy preferred
- Ability to complete a background check and, depending on the position, a drug screen
- Ability to work in a professional office environment
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, mission-driven culture
- Minimal travel flexibility preferred