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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient access management, reimbursement processes, and stakeholder engagement within the healthcare industry. Proficient in educating healthcare providers on patient support programs and navigating payer policies.
Highest-signal resume keywords
Patient Access ManagementReimbursement ProcessesPrior Authorization ExperienceStakeholder EngagementHealthcare Provider Education
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
BillingCodingReimbursement SupportMedical Benefit VerificationPrior AuthorizationPolicy SurveillanceSpecialty Product KnowledgePayer Policy KnowledgeClaims ResolutionPatient Assistance Programs
Soft Skills
Communication SkillsCollaborationEducation and TrainingProblem-SolvingStakeholder Engagement
Tools & Technologies
Web-Based Provider ToolsPatient Support ServicesSOPsBRDs
Industry Keywords
PharmaHealthcareSpecialty ProductsHCPsPayersMedicareMedicaidDermatologyPatient Support ProgramsCompliance with HIPAA
About the role
Key responsibilities & impact- Solve complex patient access issues across the Hub and provider offices while communicating with the client field team
- Partner with Sales, Payer Teams, Marketing, HCPs, and specialty pharmacies on strategic reimbursement support approaches
- Educate HCPs and office staff on Patient Support Programs, operating policies, and patient journeys
- Lead onsite education for HCP offices on program rules, payer coverage, J-codes, and reimbursement activities
- Guide healthcare providers through prior authorization and appeals processes
- Manage daily activities supporting patient access to client products across relevant sites of care
- Review billing and coding, resolve reimbursement issues, and provide education to prevent future hurdles
- Coordinate with patient support services representatives on patient cases and claim issues
- Educate office staff on patient assistance and reimbursement support services and web-based provider tools
- Conduct policy surveillance across regional payers
- Educate providers on local payer coverage and reimbursement trends through educational programs
- Lead sales training related to product reimbursement
- Communicate reimbursement concerns to internal stakeholders, including Sales and Managed Markets
- Monitor national and regional payer trends and changes
- Collaborate with Managed Markets to escalate potential payer issues
- Operate in compliance with HIPAA and program guidelines
- Meet training deadlines for corporate policies governing confidential data
- Follow all SOPs and BRDs consistently
Requirements
What you’ll need- Associate's degree or higher in a related field or equivalent market experience
- 3+ years in the Pharma/Healthcare industry, working with specialty products, Hubs, Payers, HCPs, or related areas
- Direct experience with specialty dermatology products preferred
- Specific practice management, billing, and/or coding experience for drugs, biologicals, or devices
- General payer policy knowledge, including public and private payers
- Foundational knowledge of medical benefit verifications and prior authorization/pre-determination requirements
- Knowledge of reimbursement processes within various sites of care
- Ability to conduct virtual and field-based reimbursement support and education
- Experience with prior authorizations, reimbursement billing, coding, and appeals processes
- Knowledge of commercial payer, Medicare, and Medicaid structures, systems, and reimbursement processes
- Strong stakeholder engagement and communication skills
- Valid driver's license when travel is required
- Ability to type at least 35 words per minute with 97% accuracy preferred
- Successful completion of a background check and, depending on 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 encouraging new ideas
- Inclusive workplace and mission-driven culture
- Up to 10% travel; additional travel for national meetings, training programs, and POAs