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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient benefit coordination, prior authorization processes, and healthcare billing, while maintaining strong communication and organizational skills to effectively support patients and healthcare providers.
Highest-signal resume keywords
Prior Authorization KnowledgeHealthcare Billing ExperienceCustomer Service SkillsCommunication SkillsOrganizational Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Reimbursement CoordinationInsurance ProcessingBenefit CoordinationPharmacy Insurance TerminologyMedical TerminologyData EntryProblem-SolvingDecision-MakingAttention to DetailTyping Skills
Soft Skills
Empathetic ListeningAdaptabilityReliabilityFollow-ThroughInterpersonal Skills
Tools & Technologies
Microsoft ExcelMicrosoft WordMicrosoft PowerPointMicrosoft Outlook
Industry Keywords
Patient JourneyPharmacovigilanceSOPsCall Center ExperienceHealthcare ProvidersStakeholder EngagementProgram ManagementConfidentialityEthical ConductFast-Paced Environment
About the role
Key responsibilities & impact- Provide inbound and outbound phone support to payers, patients, caregivers, specialty pharmacies, site-of-care centers, specialty distributors, pharmacy compounders, and providers
- Coordinate and monitor patient benefits, product orders, and appointments to facilitate the patient journey
- Serve as the primary or dedicated contact for internal and external stakeholders
- Explain benefit coordination, eligibility requirements, program enrollment, affordability support, and access to prescribed therapy
- Establish relationships and maintain rapport with healthcare providers and patients
- Acquire and deliver detailed program and patient information
- Navigate payer challenges and support prior authorization and appeals
- Act as liaison to client contacts, Program Management, internal stakeholders, and healthcare providers
- Maintain records according to applicable standards, regulations, program guidelines, and SOPs
- Escalate complex cases according to SOPs, Call Guides, and program materials
- Identify and report pharmacovigilance information, including adverse events and safety complaints
- Provide customer service as a brand advocate and program representative
- Communicate patient status, prescriber feedback, coordination challenges, and program effectiveness
- Assess situations and intervene as needed to obtain timely results
- Maintain confidentiality, privacy, ethical and professional conduct
- Complete required training and follow corporate policies and SOPs
- Perform miscellaneous tasks and projects assigned by Project Management
Requirements
What you’ll need- Associate or bachelor’s degree and 2 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing preferred; or, in lieu of a degree, a High School diploma or equivalent with 5 years of related experience
- Call Center/HUB or customer service experience with progressive levels of responsibility required
- Excellent oral and written communication skills
- Strong working knowledge of prior authorization and appeals required
- Strong knowledge of medical and pharmacy insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related benefit coordination
- Excellent problem-solving and decision-making skills
- Attention to detail and committed follow-through
- Strong organizational skills in a fast-paced environment
- Ability to adapt to change while maintaining Program standards
- Empathetic listening skills
- Punctual, reliable, with strong attendance record
- Strong customer service experience and skills
- Proficient with Microsoft Excel, Word, PowerPoint, and Outlook
- Ability to type at least 35 words per minute with 97% accuracy preferred
- Flexibility to travel as needed preferred
- Successful completion of a background check and, depending on the position, a drug screen
Benefits
Comp & perks- 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