Senior Patient Access and Reimbursement Navigator

Valeris; Morrisville (NC); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

HSA/FSA options

401(k) match

Paid time off

Holidays

Job summary

Valeris is hiring a Sr. Patient Navigator to guide patients through insurance verification, prior authorizations, and appeals. You will educate on access and reimbursement, build relationships with patients, prescribers, and client stakeholders, and ensure payer coverage for prescribed therapies.

Travel to HQs in Morrisville, NC or Jeffersonville, IN will be required a few times per quarter. The role demands strong knowledge of ICD-10/CPT/HCPCS, 5+ years in healthcare access, and a bachelor’s

Qualifications

• Bachelor's degree required; healthcare admin or related field preferred.
• 5–10 years in insurance reimbursement, patient access, direct patient care, or education.
• Certifications (PACS, CHES, CCM) plus 5+ years of related experience preferred.
• Minimum 2 years in healthcare access delivery or management preferred.

Responsibilities

• Serve as single point of contact delivering case management for patients, caregivers, and HCPs.
• Educate on access, reimbursement processes, payer policies, and Valeris programs.
• Build trusted relationships with patients and prescribers delivering accurate support.
• Coordinate with client field teams following agreed rules and guidelines.
• Communicate coverage options clearly and guide patients through next steps.
• Navigate benefit investigations and ensure payer coverage for prescribed treatments.
• Ensure compliance with HIPAA, Medicare/Medicaid, and Valeris SOPs.
• Identify adverse events and document activities in Valeris system.
• Support patient education and nurse teaching as applicable.
• Attend team meetings and training to stay updated on policies.

Skills

Insurance reimbursement

Patient access

Healthcare terminology

HIPAA compliance

Bilingual (plus)

Education

Bachelor's degree in healthcare administration or related field

Tools

ICD-10, CPT, HCPCS

Job description

Valeris is hiring a Sr. Patient Navigator to guide patients through insurance verification, prior authorizations, and appeals. You will educate on access and reimbursement, build relationships with patients, prescribers, and client stakeholders, and ensure payer coverage for prescribed therapies.

Travel to HQs in Morrisville, NC or Jeffersonville, IN will be required a few times per quarter. The role demands strong knowledge of ICD-10/CPT/HCPCS, 5+ years in healthcare access, and a bachelor’s