Reimbursement Program Lead | Patient Access & QA

Valeris; Charlotte (NC); In loco; USD 65.000 - 90.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, vision plans

401(k) with company match

Paid holidays

Career growth opportunities

Descrizione del lavoro

Valeris is seeking a Program Supervisor to oversee reimbursement support and ensure compliant, efficient billing workflows within a professional office setting in North Carolina. The role focuses on directing daily operations, coaching staff, and maintaining adherence to policies and procedures related to insurance coverage and access for complex pharmaceuticals.

The position requires a Bachelor’s degree or equivalent reimbursement experience, knowledge of Medicare/Medicaid/payor practices, and

Competenze

• Bachelor's degree and 2 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 4 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing

Mansioni

• Provides organization and direction for daily reimbursement support according to the scope of services provided in the statement of work
• Evaluate and monitor Program needs, identifies unmet needs and provides recommendations for internal process improvement and workflow efficiency
• Follows program guidelines and assists with the implementation of process improvements
• Serves as an advocate to patients and healthcare professionals regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals
• Provides counsel and strategies on coverage and reimbursement issues to patients and healthcare providers, and works on patients' behalf to identify and assess reimbursement coverage options
• Problem solves issues with autonomy and serves as first line of escalation for complex reimbursement issues
• Routinely conducts quality assurance activities through reviews, meetings, reports, observation of results, according to standard operating procedures, program specific procedures and regulatory compliance
• Responsible for performance management including but not limited to, coaching and mentoring subordinates, employee counseling, employee performance appraisals, conflict resolution and schedule adherence.
• On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
• Conducts miscellaneous tasks or projects as assigned

Conoscenze

Reimbursement knowledge

Healthcare billing

Coaching / performance management

Formazione

Bachelor's degree

Strumenti

MS Office

Descrizione del lavoro

Valeris is seeking a Program Supervisor to oversee reimbursement support and ensure compliant, efficient billing workflows within a professional office setting in North Carolina. The role focuses on directing daily operations, coaching staff, and maintaining adherence to policies and procedures related to insurance coverage and access for complex pharmaceuticals.

The position requires a Bachelor’s degree or equivalent reimbursement experience, knowledge of Medicare/Medicaid/payor practices, and