Trades Medical Benefit Specialist

Valeris

. Manage day-to-day activities and escalations for assigned medical benefit copay programs .

Posted 9/15/2026full-timeRemote • North Carolina • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical claims processing, including rejection troubleshooting and provider workflows, while effectively managing customer service interactions and stakeholder communications. Proven ability to analyze complex situations, recommend improvements, and maintain compliance with confidentiality and privacy standards.

Highest-signal resume keywords

Medical Claims ProcessingCustomer ServiceVerbal And Written CommunicationProblem-Solving SkillsVendor Management

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medical Claims WorkflowsRejection TroubleshootingData AnalysisMicrosoft Excel ProficiencyTyping Speed Of 35 Words Per Minute

Soft Skills

Interpersonal SkillsCollaboration SkillsOrganizational SkillsDetail-OrientedAbility To Multitask

Industry Keywords

Medical Benefit ProgramsConfidentialityProgram RegulationsStakeholder EngagementContinuing Education

About the role

Key responsibilities & impact

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

What you’ll need

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

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