Care Coordinator

Overview

Mercalis is the leading integrated commercialization partner for life sciences companies. We deliver end-to-end commercial solutions that work together to provide patient support services, healthcare provider engagement, and payer intelligence and strategic consulting. Backed by proven industry expertise and results-driven technology, Mercalis helps navigate the complex life sciences marketplace to accelerate value, enhancing business results and patient lives.

Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success. We are a diversity-driven team with an inclusive approach to delivering patient-centric solutions that eliminate barriers for patients, increase access to medications, and help patients receive life-saving treatments. At Mercalis, we believe happy, healthy people are passionate and engaged—and bring that attitude to work. We see ourselves as innovators, creators, and leaders that solve problems with visionary solutions.

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 delivery of services.

Responsibilities

• Care Coordinator will serve as an advocate to patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy.
• Care coordinator will provide the highest level of white glove customer service with utmost empathy and accountability and will not back down in exhausting all available resources in providing resolution to overcome patient’s barrier to therapy
• Navigates patients in overcoming payer challenges by asking appropriate questions, trouble shooting and walking them through alternative copay solutions in overcoming patient affordability issues
• Establishes relationships, develop trust, and maintain rapport with healthcare providers and/or patients
• Serves as direct 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
• 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) - is preferred.
• Maintains records in accordance with applicable standards and regulations to the programs/promotions
• Follows program guidelines and escalates complex cases according to SOPs, Call Guides, and other program materials.
• Liaison between account 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 commit to the appropriate use of resources
• As a program’s “eyes and ears”, works with Program Supervisor  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 positive attitude and strong work ethics
• Utilizes the necessary resources for conflict resolution as needed
• Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events)
• Other responsibilities as assigned by Program Supervisor/Program Manager

Qualifications

• Associate or bachelor’s degree and 3 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 (through both inbound and outbound outreach)

• Excellent communication skills; orally and in writing

• 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 and proficient in Microsoft products (Excel, Word, PowerPoint and Outlook)
• Willing to work in a dynamic, fast paced environment and can multi-task
• Ability to, and help team, adapt to change while maintaining Program standards
• Strong team player willing to jump in and help other team members when needed
• Empathetic listening skills in order to interact effectively with patients and providers
• Punctual, reliable with strong attendance record