Patient Benefits Navigator

Valeris, Inc.; Jeffersonville (IN); On-site; USD 38,000 - 52,000; Full time

Benefits offered by this job

Medical, dental and vision plans

HSA- and FSA-eligible options

401(k) Retirement Savings Plan with 1:

Paid Time Off and holidays

Job summary

Valeris in Indiana is seeking a Benefits Specialist to provide telephonic and web-based customer service, answering inquiries, processing service requests, assessing benefits coverage, and helping patients access therapy in a compliant manner.

You will verify patient benefits for major plans, coordinate prior authorizations, review enrollment forms, communicate eligibility to patients and providers, and ensure timely feedback while using PharmaCord Lynk to move claims through workflows.

Qualifications

• Bachelor's degree strongly preferred or equivalent experience.
• 6 months customer service or payer benefits experience preferred.
• Healthcare industry experience or related certification preferred.
• Bilingual is a plus.

Responsibilities

• Benefit Verification for major medical and pharmacy plans.
• Complete templates for patient benefits coverage determinations.
• Coordinate prior authorizations per payer guidelines.
• Review patient enrollment forms to assess eligibility.
• Communicate eligibility to patients, providers, and pharmacies.
• Answer inbound inquiries and assist via phone or web.
• Report adverse events and product complaints per SOP.
• Provide feedback on service failures and stay compliant.

Skills

Customer service

Communication skills

Attention to detail

Confidentiality

Bilingual (nice to have)

Empathy

Education

Bachelor's degree preferred or equivalent experience

High school diploma or GED required

Tools

PharmaCord Lynk

Job description

Valeris in Indiana is seeking a Benefits Specialist to provide telephonic and web-based customer service, answering inquiries, processing service requests, assessing benefits coverage, and helping patients access therapy in a compliant manner.

You will verify patient benefits for major plans, coordinate prior authorizations, review enrollment forms, communicate eligibility to patients and providers, and ensure timely feedback while using PharmaCord Lynk to move claims through workflows.