Sr. Patient Navigator

Valeris; Morrisville (NC); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, dental & vision plans

HSA/FSA benefits

401(k) match

PTO & sick leave

Holidays

Job summary

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

You will educate patients and healthcare providers on access and reimbursement pathways while maintaining compliant processes under HIPAA and other regulations. This role requires coordinating with client teams, handling benefit investigations, and documenting activities in Valeris’ systems.

Qualifications

• Bachelor’s degree in healthcare administration, social science, or related field.
• 5–10 years in insurance reimbursement, patient access, or related fields.
• Strong knowledge of ICD-10, CPT, HCPCS coding and insurance processes.
• Excellent communication with patients, providers, and payers.

Responsibilities

• Serve as primary contact for patients, caregivers, and healthcare providers.
• Manage benefit investigations, prior authorization tracking, and appeals.
• Educate patients and providers on access, coverage, and program options.
• Build trustful relationships and ensure compliant reimbursement support.
• Coordinate with client field teams under established guidelines.
• Document activities in Valeris system and maintain records.
• Travel as required by client: HQ proximity within 30 miles of Morrisville NC or Jeffersonville IN.

Skills

Insurance reimbursement

Patient access

Prior authorization

Appeals support

HIPAA compliance

Education for patients and HCPs

Relationship management

Medical terminology

Education

Bachelor's degree

PACS/CHES/CCM certifications

Job description

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.

• Shifts Available: 9AM - 6PM (9); 10AM - 7PM (4), 11AM - 8PM (3)***

The Sr. Patient Navigator plays a critical role in ensuring patients have access to life-altering medications by supporting them through complex processes such as insurance verification, prior authorizations, and appeals. This position combines exceptional customer service, relationship management, and expertise in reimbursement practices to provide personalized support and ensure compliance with all healthcare regulations. The role also focuses on educating healthcare providers and patients on access, coverage, and reimbursement support. These roles will be regionally aligned to best support patients.

Key Responsibilities

• Serves as the single point of contact and provides personalized case management for patients, caregivers, and healthcare providers (HCPs), including delivery of benefit investigations, prior authorization tracking, and appeal support.
• Educate patients, HCPs, and stakeholders on access and reimbursement processes, payer policies, and Valeris programs (e.g., patient assistance programs, copay programs).
• Build and maintain trusted relationships with patients, prescribers, and client stakeholders by delivering accurate, timely, and compassionate support.
• Coordinate and collaborate with client field teams, following agreed upon business rules and guidelines
• Communicate benefit coverage options and next steps in the patient journey using clear and patient-friendly language.
• Leverage electronic tools to navigate and complete benefit investigations, ensuring payer coverage is secured for prescribed treatments.
• Ensure all activities comply with healthcare laws, regulations, and Valeris standard operating procedures (e.g., HIPAA, insurance guidelines).
• Identify and elevate adverse events, product complaints, and special situation reports as required by the program.
• Document all activities in the Valeris system, maintaining detailed and accurate records.
• Support adherence services, including patient education and coordinating nurse teaching as applicable.
• Participate in team meetings and ongoing training to stay updated on policies and procedures.
• Travel WILL BE required per client request a few times per quarter. Travel will be designated to the HQ closest to the selected candidate(s) in either Morrisville, NC or Jeffersonville, IN - therefore desired candidate(s) must live within 30 miles of either HQ.
• Utilize Valeris' values as the driving force behind the team's success
• On time adherence to training deadlines for all corporate policies and procedures
• Ensure all SOPs are followed with consistency
• Perform additional tasks or projects as assigned

Qualifications

• Bachelor's degree required, preferably in healthcare administration, social science, or a related field.
• • In lieu of a degree, candidates may qualify with:
  • 5-10 years of relevant experience in areas such as insurance reimbursement, patient access, direct patient care, or patient education, or
  • Relevant certifications (e.g., PACS, CHES, or CCM) plus at least 5 consecutive years of related experience.
  • Minimum two (2) years of experience in healthcare access delivery or management is strongly preferred.
  • Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
  • Ability to prioritize tasks and work efficiently in a fast-paced environment
  • Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.
  • Bilingual / Multilingual is a plus.

Physical Demands & Work Environment

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
• Although very minimal, flexibility to travel as needed is preferred.
• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.

Why Work for Valeris?

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
• Additional health support, including telehealth and Employee Assistance Program (EAP) services
• Company match on Health Savings Account contributions
• Free Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
• Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
• 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
• Paid Time Off (PTO) and Sick Leave to support work-life balance
• Team members receive nine paid holidays plus two floating holidays
• Opportunities for advancement in a company that supports personal and professional growth
• A challenging, stimulating work environment that encourages new ideas
• Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
• A mission-driven, inclusive culture where your work makes a meaningful impact

Any offer of employment is contingent upon the successful completion of a background check and, depending on the role, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.

Our Commitment to Equal Opportunity

At Valeris, we don't just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.