Trades Medical Benefit Specialist

🔥 19 hours ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Valeris

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💊 Pharmaceuticals

🏥 Healthcare

🤝 B2B

Pharmaceuticals • Healthcare • B2B

Valeris is a fully integrated life sciences commercialization partner formed by the merger of PharmaCord and Mercalis. The company provides comprehensive solutions across the healthcare value chain to help life sciences companies bring products to market and improve patient access and adherence. Valeris offers data and strategic insights, patient support and access programs, and healthcare provider engagement tools, serving over 500 life sciences customers and supporting millions of patients. Headquartered in Morrisville, North Carolina and Jeffersonville, Indiana, Valeris focuses on enabling commercialization and patient-centric services for pharmaceutical and life sciences organizations.

📋 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

🎯 Requirements

• 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

🏖️ Benefits

• 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