Senior Access & Reimbursement Case Manager

Valeris, Inc.; Jeffersonville (IN); In loco; USD 60.000 - 90.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical insurance

Dental/Vision insurance

401(k) match

Paid time off

Paid holidays

Descrizione del lavoro

Valeris, Inc. is seeking an Executive Case Manager to advise on insurance coverage and reimbursement challenges affecting patients and healthcare providers. The role educates on access tools, supports patient and HCP decisions, and ensures compliant communication with client teams.

The position emphasizes benefits investigations, payor interactions, and personalized case management to improve access to prescribed medicines, in a HIPAA-compliant environment.

Competenze

• Bachelor's degree (or higher) required or strongly preferred.
• Minimum two years of experience in healthcare access delivery or management preferred.
• 5–10 years in insurance reimbursement, patient access, direct patient care, or patient education may substitute for degree.
• Certifications such as PACS, CHES, or CCM are a plus.
• Strong understanding of medical terminology and insurance processes (ICD-10, CPT, HCPCS).
• Bi-lingual skills are a plus.

Mansioni

• Builds trusted relationships with patients, prescribers, and clients regarding reimbursement inquiries and challenges.
• Educates on access and reimbursement tools and Payor processes.
• Manages inbound/outbound calls from patients, caregivers, and healthcare professionals.
• Performs benefits investigations and communicates coverage options and steps.
• Documents activities in the Lynk system and generates reports to identify trends.

Conoscenze

Healthcare knowledge

Communication skills

HIPAA compliance

Prior authorization knowledge

Bi-lingual helpful

Relationship management

Formazione

Bachelor's degree or higher

Strumenti

PharmaCord Lynk system

Descrizione del lavoro

Valeris, Inc. is seeking an Executive Case Manager to advise on insurance coverage and reimbursement challenges affecting patients and healthcare providers. The role educates on access tools, supports patient and HCP decisions, and ensures compliant communication with client teams.

The position emphasizes benefits investigations, payor interactions, and personalized case management to improve access to prescribed medicines, in a HIPAA-compliant environment.