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Valeris
Valeris
1001 – 5000 Darbinieki
B2BFarmaceitiskie produktiVeselības aprūpe
Valeris ir dzīvības zinātņu komercializācijas uzņēmums, kas izveidots, apvienojoties PharmaCord un Mercalis. Tas palīdz farmācijas un citu dzīvības zinātņu organizācijām ieviest produktus tirgū, uzlabot pacientu piekļuvi ārstēšanai un līdzestību ārstēšanai, kā arī iesaistīt veselības aprūpes pakalpojumu sniedzējus. Uzņēmuma pakalpojumi ietver datus un stratēģiskās atziņas, pacientu atbalsta un piekļuves ārstēšanai programmas, kā arī rīkus veselības aprūpes pakalpojumu sniedzēju iesaistei. Valeris sadarbojas ar vairāk nekā 500 dzīvības zinātņu jomas klientiem un atbalsta miljoniem pacientu visā veselības aprūpes vērtības ķēdē. Uzņēmuma darbības centri atrodas Morisvilā, Ziemeļkarolīnā, un Džefersonvilā, Indiānā.
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Vakances uzņēmumā

Bilingual Executive Care Coordinator - Valeris Remote

Guide patients through insurance reimbursement and access to complex medications as a bilingual Executive Care Coordinator. Support life sciences commercialization through case management, benefit investigations, and coverage resolution.

USAmerikas Savienotās ValstisAZArizonaNCZiemeļkarolīnaAttālinātiPilna slodzeJaunākais speciālistsVidējais līmenisNepieciešamā Valoda: angļuNepieciešamā Valoda: spāņuDivvalodīgs

Apraksts

  • Manage each patient case from enrollment through closure.
  • Conduct benefit investigations and monitor prior authorizations and denial appeals.
  • Support patients, callers, and stakeholders through resolution using email, inbound and outbound calls, and Lynk.
  • Explain coverage options and required next steps to patients and physicians.
  • Handle inquiries from patients, prescribers, healthcare providers, clients, specialty pharmacies, and payers.
  • Refer patients to appropriate internal or external resources.
  • Deliver individualized case management and explain coverage and access next steps.
  • Determine requirements for prior authorizations, appeals, tier exceptions, and formulary exclusions.
  • Follow up with payers and healthcare providers regarding submissions and decisions.
  • Coordinate nurse education sessions and support adherence services.
  • Locate peer support resources and communicate reverification or re-enrollment requirements.
  • Identify and report adverse events, product complaints, special situation reports, and medical inquiries.
  • Record reimbursement activity, claim status, payments, and appeals in Lynk.
  • Prepare reports and analyze data to identify trends and improvement opportunities.
  • Act as a subject matter expert while following SOPs, business rules, training deadlines, and compliance requirements.

Prasības

  • Fluency in both Spanish and English is required.
  • A bachelor's degree or higher is required.
  • Five or more years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education may substitute for a degree.
  • At least two years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education is required.
  • At least two years of experience in healthcare access delivery or management is strongly preferred.
  • Strong knowledge of medical terminology, ICD-10, CPT, HCPCS, and insurance processes.
  • Working knowledge of HIPAA and Medicare and Medicaid guidelines.
  • Excellent attention to detail and organizational ability.
  • Ability to prioritize work and operate efficiently in a fast-paced environment.
  • Strong written, verbal, and interpersonal communication skills.
  • Critical-thinking and issue-resolution skills.
  • Ability to satisfy work-from-home criteria, subject to business needs.
  • Candidates who can type at least 35 words per minute with 97% accuracy are preferred.
  • A background check and, where applicable, a drug screen are required as a condition of employment.

Priekšrocības

  • Medical, dental, and vision plans include HSA- and FSA-eligible options, with Valeris contributing toward premium costs.
  • Telehealth and Employee Assistance Program services.
  • Company matching contributions to Health Savings Accounts.
  • Free Basic Life and AD&D coverage equal to annual earnings, with a $50,000 minimum and $300,000 maximum.
  • Company-paid Short-Term Disability coverage, with Long-Term Disability available for purchase.
  • 401(k) Retirement Savings Plan with a 100% match on the first 5% contributed and immediate vesting.
  • Paid Time Off and Sick Leave.
  • Nine paid holidays and two floating holidays.
  • Opportunities for advancement and personal and professional growth.
  • A challenging, stimulating work environment that encourages new ideas.
  • An inclusive workplace and mission-driven culture.
  • Minimal travel flexibility is preferred.

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