Executive

• Own 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 and inbound/outbound calls
• Provide education on access and reimbursement support tools, benefits, and program eligibility
• Educate healthcare provider offices on payer processes and procedures
• Build and maintain relationships with patients, prescribers, and client stakeholders
• Handle inbound calls according to program-approved FAQs and triage patients to appropriate resources
• Manage client and healthcare provider inquiries
• Provide personalized case management and communicate next steps for obtaining medication coverage and access
• Identify and communicate coverage requirements, including prior authorization, appeals, tier exceptions, and formulary exclusions
• Use electronic tools and manual investigations to determine benefits and payer coverage
• Follow up with payers and healthcare providers on submissions and outcomes
• Coordinate nurse teaching with nurse educators and support adherence services
• Identify peer support resources and proactively communicate re-verification or re-enrollment needs
• Identify and report adverse events, product complaints, special situation reports, and medical inquiries
• Document reimbursement activities in the Lynk system, including claims status, payments, and appeals
• Generate reports and analyses to identify trends and improvement opportunities
• Follow SOPs, corporate policies, and program operating procedures
• Perform additional assigned tasks and projects

Explore Executive Care Coordinator at Valeris. Review requirements and application details.