Reimbursement Case Manager: Patient Access Advocate

Valeris, Inc.; North Carolina; Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical, dental, vision plans

Paid time off and holidays

401(k) with employer match

Employee assistance program

Life and disability coverage

Job summary

Valeris, Inc. in Morrisville, NC is seeking a Reimbursement Case Manager to act as the primary contact for patients, caregivers, and providers, coordinating resources and guiding the patient through the program to access life-saving therapies.

You will manage daily payer interactions, verify benefits, enrollment, and appeals while maintaining HIPAA-compliant records and delivering exceptional customer service.

Qualifications

• Associate or Bachelor’s degree preferred; or a minimum of 4 years of call center or customer service experience.
• Ability to communicate effectively both orally and in writing.
• Knowledge of medical insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related experience.
• Excellent problem-solving and decision-making skills required.
• Attention to detail and committed follow through in communication with patients, providers and internal stakeholders.
• Strong organizational skills.
• Willing to work in a dynamic, fast paced environment and have the ability to multi-task and adapt to change while adhering to Program Standards.
• Strong interpersonal skills, ability to work both independently and as part of a team, ability to jump in and help others as needed.
• Empathetic listening skills in order to interact effectively with patients and providers.
• Punctual, reliable with strong attendance record.
• Proficient with Microsoft products

Responsibilities

• Provide inbound and outbound phone support to patients, caregivers and providers.
• Coordinate resources and monitor patient needs through the Patient Support Program.
• Verify insurance benefits and aid program enrollment and approvals.
• Communicate clearly with payers, prescribers and customers.
• Document interactions in the case management system and maintain HIPAA-compliant records.
• Assist in PA/Appeals process and patient status updates.
• Support program guidelines and SOPs and escalate complex cases as needed.
• Maintain strong relationships with health care providers and internal stakeholders.

Skills

Effective communication

Problem-solving

Detail-oriented

Strong organizational skills

Empathetic listening

Independent and team work

Proficient in Microsoft Office

Education

Associate degree preferred

Bachelor’s degree preferred

Tools

Microsoft Office

Job description

Valeris, Inc. in Morrisville, NC is seeking a Reimbursement Case Manager to act as the primary contact for patients, caregivers, and providers, coordinating resources and guiding the patient through the program to access life-saving therapies.

You will manage daily payer interactions, verify benefits, enrollment, and appeals while maintaining HIPAA-compliant records and delivering exceptional customer service.