Remote Medical Benefit & Claims Specialist

Valeris; North Carolina; Remote; USD 55,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

401(k) Retirement Savings Plan with a

Paid Time Off

Job summary

Valeris is hiring a Medical Benefit Specialist to manage day-to-day medical copay program activities and escalations. You will serve as a liaison between provider offices, patients, and stakeholders, ensuring accurate claim status and timely resolutions.

The role supports pharmaceutical reps at sites as needed and requires strong communication, data review, and problem-solving skills. Ideal candidates will have 5+ years in customer service or medical claims, proficiency with MS Excel, and a

Qualifications

• Minimum 5 years of customer service/medical claim experience is preferred.
• Proven understanding of medical claims processing, rejections, reversals/adjustments, and provider workflows.

Responsibilities

• Manages day-to-day activities and escalations of multiple medical benefit copay programs.
• Acts as focal point for provider medical claim escalations and outreach to providers and patients.
• Delivers detailed information for various medical claim situations and provides exceptional customer service.
• Collaborates with vendors and internal teams to document, escalate, and resolve issues.

Skills

Customer service

Medical claims processing

Verbal and written communication

Vendor management

Multitasking

Attention to detail

Problem solving

Education

Associate or Bachelor’s degree preferred

Tools

MS Excel

Job description

Valeris is hiring a Medical Benefit Specialist to manage day-to-day medical copay program activities and escalations. You will serve as a liaison between provider offices, patients, and stakeholders, ensuring accurate claim status and timely resolutions.

The role supports pharmaceutical reps at sites as needed and requires strong communication, data review, and problem-solving skills. Ideal candidates will have 5+ years in customer service or medical claims, proficiency with MS Excel, and a