Trades Medical Benefit Specialist

🕒 il y a 1 mois

🌲 North Carolina – Distant

🌲 North Carolina – Remote

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👻 Score fantôme 21%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Valeris

Site WebLinkedInTous les Emplois

1001 - 5000 employés

💊 Pharmaceutique

🏥 Santé

🤝 B2B

Pharmaceuticals • Healthcare • B2B

Valeris est un partenaire de commercialisation intégré dans le domaine des sciences de la vie, issu de la fusion de PharmaCord et Mercalis. L'entreprise propose des solutions complètes sur toute la chaîne de valeur des soins de santé pour aider les entreprises des sciences de la vie à commercialiser leurs produits et à améliorer l'accès et l'observance des patients. Valeris offre des données et des informations stratégiques, des programmes de soutien et d'accès pour les patients, ainsi que des outils d'engagement pour les fournisseurs de soins de santé, en servant plus de 500 clients dans le secteur des sciences de la vie et en aidant des millions de patients. Basée à Morrisville, en Caroline du Nord, et à Jeffersonville, dans l'Indiana, Valeris se concentre sur la facilitation de la commercialisation et des services centrés sur le patient pour les organisations pharmaceutiques et des sciences de la vie.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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