Senior Patient Access & Reimbursement Navigator

Valeris, Inc.; North Carolina; Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health benefits

Telehealth & EAP

401(k) match

Paid time off

Holidays & leave

Career growth

Job summary

Valeris, Inc. is seeking a Sr. Patient Navigator to ensure patients gain access to life-changing medications through insurance verification, prior authorizations, and appeals.

You will educate providers and patients on access, coverage, and reimbursement programs, while managing cases and maintaining strong relationships. You will collaborate with client field teams, adhere to healthcare regulations, document activities thoroughly, and support adherence services.

Qualifications

• Bachelor's degree required, preferably in healthcare administration or related field.
• 5-10 years of experience in insurance reimbursement, patient access, direct patient care, or patient education, or relevant certifications with at least 5 consecutive years of related experience.
• Minimum two years of experience in healthcare access delivery or management is preferred.
• Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
• Knowledge of HIPAA and Medicare/Medicaid guidelines.
• Bilingual/multilingual is a plus.

Responsibilities

• Serve as the single point of contact providing personalized case management for patients, caregivers, and healthcare providers, including benefit investigations and prior authorization tracking.
• Educate patients, HCPs, and stakeholders on access, payer policies, and Valeris programs.
• Build and maintain trusted relationships with patients, prescribers, and client stakeholders with accurate, timely support.
• Coordinate with client field teams following agreed-upon business rules and guidelines.
• Communicate benefit coverage options and next steps in the patient journey in clear terms.
• Document all activities in the Valeris system with detailed records.
• Travel may be required per client request a few times per quarter.

Skills

Healthcare access

Medical terminology

HIPAA

Prioritization

Bilingual

Education

Bachelor's degree in healthcare administration

5-10 years relevant experience

Job description

Valeris, Inc. is seeking a Sr. Patient Navigator to ensure patients gain access to life-changing medications through insurance verification, prior authorizations, and appeals.

You will educate providers and patients on access, coverage, and reimbursement programs, while managing cases and maintaining strong relationships. You will collaborate with client field teams, adhere to healthcare regulations, document activities thoroughly, and support adherence services.