Reimbursement Case Manager

Valeris

. Provide inbound and outbound phone support as the primary contact for patients, caregivers and providers .

Posted 9/29/2026full-timeRemote • North Carolina • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in patient advocacy, reimbursement processes, and healthcare insurance interactions while maintaining strong organizational and communication skills. Capable of effectively managing patient journeys and collaborating with healthcare providers to ensure access to prescribed therapies.

Highest-signal resume keywords

Reimbursement ExpertisePatient AdvocacyHealthcare Insurance KnowledgeEffective CommunicationOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingInsurance Benefit InvestigationData Integrity EvaluationPrior Authorization AssistanceCall Center ExperienceCustomer ServiceHealthcare ProcessingTyping ProficiencyAttention to DetailProblem-Solving

Soft Skills

Empathetic ListeningInterpersonal SkillsAdaptabilityTeam CollaborationReliability

Tools & Technologies

Case Management SystemMicrosoft Products

Industry Keywords

Patient Support ProgramEligibilityEnrollmentAffordability SupportSOPsConfidentialityHealthcare ProvidersPayersMedicareMedicaid

About the role

Key responsibilities & impact

Provide inbound and outbound phone support as the primary contact for patients, caregivers and providers
Facilitate and monitor patients’ journeys through Patient Support Program services on behalf of a manufacturer
Handle day-to-day reimbursement services and interactions with healthcare insurance companies
Serve as an expert on reimbursement, co-pay, foundation assistance, PAP issues and other available support
Advocate for patients regarding eligibility, enrollment, reimbursement, affordability support and access to prescribed therapy
Establish relationships and maintain rapport with patients, payers and healthcare providers
Provide healthcare providers with detailed program and patient information
Verify insurance coverage, medical billing, reimbursement processes and access for complex pharmaceuticals
Evaluate enrollment forms for data integrity
Conduct insurance benefit investigations and triage cases according to standard operating procedures
Follow program guidelines and escalate complex cases according to policies, SOPs, Call Guides and other materials
Document case status and background in the case management system
Communicate patient benefits and assist with prior authorization and appeals processes
Explain benefits offered by private/commercial and government payers, including Medicare, Medicaid, VA and DOD
Liaise with client contacts, Program Management, internal stakeholders and healthcare providers
Maintain records according to applicable standards and regulations
Collaborate with the Program Manager regarding patient status, prescriber feedback, satisfaction and program effectiveness
Understand patients’ health and disease states
Maintain confidentiality, privacy, ethical conduct and adherence to SOPs
Perform additional assigned tasks or projects

Requirements

What you’ll need

Associate or Bachelor’s degree preferred; or a minimum of 4 years of call center or customer service experience with progressive levels of responsibility within a service-driven environment
Ability to communicate effectively both orally and in writing
Knowledge of medical insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related experience
Excellent problem-solving and decision-making skills
Attention to detail and committed follow-through in communication with patients, providers and internal stakeholders
Strong organizational skills
Ability to work in a dynamic, fast-paced environment, multitask and adapt to change while adhering to Program Standards
Strong interpersonal skills and ability to work independently and as part of a team
Empathetic listening skills
Punctual, reliable with strong attendance record
Proficient with Microsoft products
Ability to type at least 35 words per minute with 97% accuracy preferred
Flexibility to travel as needed preferred
Must successfully complete 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
Background check and, depending on the position, drug screen in accordance with company standards