Trades Medical Benefit Specialist

🕒 Setembro 15

🌲 North Carolina – Remoto

🌲 North Carolina – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👻 Score fantasma 11%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

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Valeris

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

💊 Farmacêutico

🏥 Saúde

🤝 B2B

Pharmaceuticals • Healthcare • B2B

A Valeris é um parceiro totalmente integrado de comercialização em ciências da vida, formada pela fusão da PharmaCord e da Mercalis. A empresa oferece soluções abrangentes ao longo da cadeia de valor da saúde para ajudar as empresas de ciências da vida a levar produtos ao mercado e melhorar o acesso e a adesão dos pacientes. Valeris oferece dados e insights estratégicos, programas de suporte e acesso a pacientes e ferramentas de engajamento de prestadores de saúde, atendendo a mais de 500 clientes de ciências da vida e apoiando milhões de pacientes. Com sedes em Morrisville, Carolina do Norte, e Jeffersonville, Indiana, a Valeris se concentra em viabilizar a comercialização e serviços centrados no paciente para organizações farmacêuticas e de ciências da vida.

Descrição

• Manage day-to-day activities and escalations for assigned medical benefit copay programs • Assist stakeholders as an advocate by providing detailed information for medical claim situations • Serve as focal point for provider medical claim escalations • Conduct verbal and written outreach to provider sites, patients, and other stakeholders • Provide customer service as a service representative • Analyze situations, interpret information, draw conclusions, and determine appropriate actions • Support pharmaceutical representatives and their sites regarding medical benefit programs • Investigate end-to-end medical claim scenarios and determine resolutions • Maintain ethical conduct regarding confidentiality and privacy • Maintain records according to applicable standards and program regulations • Evaluate programs and recommend new tools, forms, and procedures • Participate in program meetings and improvement initiatives • Collaborate with vendors and internal stakeholders to document, escalate, and resolve issues • Participate in continuing education activities to remain knowledgeable about programs and related areas

🎯 Requisitos

• Associate or Bachelor’s degree preferred; or a minimum of 5 years of customer service/medical claim experience • Strong understanding of medical claims processing, rejection troubleshooting, reversals/adjustments, and provider medical claims workflows a plus • Articulate verbal and written communication • Proficiency with Microsoft products, including MS Excel and reviewing data sets • Ability to liaise between client-facing teams and technology and operational delivery teams • Ability to manage and prioritize competing demands • Customer service and collaboration skills • Experience managing vendors, contractors, and subcontractors • Proven problem-solving and organizational skills for managing escalations • Logical, efficient, detail-oriented, and committed follow-through • Ability to multitask in a dynamic, fast-paced environment • Strong interpersonal skills and ability to work independently and as part of a team • Ability to type at least 35 words per minute with 97% accuracy preferred • Successful completion of a background check and, depending on the position, a drug screen

🏖️ Benefícios

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs • Telehealth and Employee Assistance Program (EAP) services • Company match on Health Savings Account contributions • Free Basic Life and AD&D coverage equal to 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% contributed, with immediate vesting • Paid Time Off (PTO) and Sick Leave • Nine paid holidays plus two floating holidays • Opportunities for advancement and personal and professional growth • Challenging, stimulating work environment that encourages new ideas • Inclusive workplace and mission-driven culture • Minimal travel flexibility preferred