Healthcare Reimbursement Program Lead

Valeris; Clayton (NC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

HSA- and FSA- eligible options

401(k) Retirement Savings Plan with %

Company match on Health Savings

Short-Term Disability coverage

9 paid holidays + 2 floating holidays

Career growth opportunities

Diversity & inclusion

Job summary

Valeris seeks a Program Supervisor to lead reimbursement and administrative activities, coordinating services within the department. You will coach staff, manage performance, and ensure adherence to policies for complex pharmaceutical access programs.

The role emphasizes monitoring program needs, guiding reimbursement processes, and providing escalation support for challenging cases, while promoting quality assurance and regulatory compliance.

Qualifications

• Extensive knowledge of Medicare, Medicaid, and private payer payment methodologies.
• Experience handling insurance coverage and reimbursement workflows.
• Ability to educate patients and providers on reimbursement options.

Responsibilities

• Provide organization and direction for daily reimbursement support per the statement of work.
• Evaluate program needs and recommend process improvements to enhance efficiency.
• Assist with implementation of program guidelines and SOPs.
• Advocate to patients and providers regarding insurance coverage and access to medications.
• Counsel on coverage options for patients and healthcare providers.

Skills

Insurance coverage

Medical billing

Reimbursement process

Policy adherence

Education

Bachelor's degree

High School diploma or equivalent

Job description

Valeris seeks a Program Supervisor to lead reimbursement and administrative activities, coordinating services within the department. You will coach staff, manage performance, and ensure adherence to policies for complex pharmaceutical access programs.

The role emphasizes monitoring program needs, guiding reimbursement processes, and providing escalation support for challenging cases, while promoting quality assurance and regulatory compliance.