Reimbursement Case Manager

Valeris

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

Posted 11/2/2026full-timeRemote • North Carolina • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in patient support program management, including reimbursement processes, insurance verification, and effective communication with patients and healthcare providers. Proficient in maintaining data integrity and adhering to program standards while providing empathetic support.

Highest-signal resume keywords

Patient Support Program ManagementMedical Insurance TerminologyReimbursement ProcessesEffective CommunicationAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Reimbursement ServicesInsurance VerificationMedical BillingHealthcare Insurance ProcessingData Integrity EvaluationPrior Authorization AssistanceCase Management System ProficiencyTyping Speed of 35 Words Per MinuteMicrosoft Products Proficiency

Soft Skills

Empathetic ListeningProblem-SolvingOrganizational SkillsInterpersonal SkillsAdaptability

Industry Keywords

Patient JourneyHealthcare ProvidersPayersMedicareMedicaidVADODSOPsProgram GuidelinesConfidentiality

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
Handle day-to-day reimbursement services and interact with healthcare insurance companies to verify financial aspects of healthcare services
Advise patients on eligibility requirements, program enrollment, reimbursement processes, affordability support, and access to prescribed therapy
Establish relationships and maintain rapport with patients, payers, and healthcare providers
Support healthcare providers with program and patient information
Verify insurance coverage, medical billing, reimbursement processes, and access for complex pharmaceuticals
Evaluate program 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 program materials
Use the case management system, document case notes, communicate patient benefits, and assist with prior authorization and appeals processes
Explain benefits for private/commercial and government payer types, 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
Work with the Program Manager to communicate patient status, prescriber feedback, satisfaction, and program effectiveness
Maintain confidentiality and privacy and follow all SOPs
Complete training deadlines and 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
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
Punctuality, reliability, and strong attendance record
Proficient with Microsoft products
Prefer candidates able to type at least 35 words per minute with 97% accuracy
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 encouraging new ideas
Inclusive workplace and mission-driven culture
Background check and, depending on position, drug screen in accordance with company standards