Reimbursement Specialist

Valeris • Remote, Indiana, IN

7d • Onsite

About The Position

Valeris is a life sciences commercialization partner formed through the merger of PharmaCord and Mercalis. The Reimbursement Specialist provides patient-focused, compliant support to patients, healthcare providers, insurance companies, medical practices, sales representatives, and pharmacies. The role involves answering inquiries, processing service requests, verifying benefits coverage, reviewing patient assistance applications, and helping address barriers to therapy access. Support is delivered by telephone and, where applicable, through web-based channels.

The position uses Valeris’ internal technology platform, PharmaCord Lynk, to process claims and manage workflows. Specialists are expected to provide high-quality customer service while following company policies, procedures, program guidelines, and SOPs. This is an office-based role in a professional office environment. It requires extended periods of sitting and routine use of office equipment. Minimal travel may be needed.

Requirements

• High school diploma or GED required.
• Bachelor’s degree strongly preferred, or equivalent experience required.
• Service-minded approach, with a focus on recognizing and meeting the needs of patients and care partners.
• Ability to handle personal health information confidentially.
• Honesty, integrity, professionalism, and appropriate business and customer-service etiquette.
• Clear verbal and written communication skills.
• Accountability for results, ability to plan and prioritize tasks, and strong attention to detail.
• Emotional intelligence, including the ability to recognize emotions and their effects.
• Ability to manage disruptive impulses and handle potentially stressful customer interactions.
• Proficient computer skills.
• Adaptability to change, personal initiative, and commitment to team and organizational goals.
• Ability to work effectively within a team.
• Ability to sit for extended periods.
• Regular ability to talk or hear; frequent sitting for long periods, use of hands to type, handle, or feel, and reaching with hands and arms.
• Must complete a background check and, depending on the position, a drug screen as a condition of employment.

Nice To Haves

• Six months of customer service experience, payer benefits experience (such as reimbursement or prior authorization), healthcare industry experience, or a healthcare-related certification, license, or equivalent coursework.
• Bilingual ability.
• Ability to type at least 35 words per minute with 97% accuracy.
• Flexibility to travel as needed, although travel is expected to be very minimal.

Responsibilities

• Perform patient-level benefits verifications for major medical and pharmacy benefit plans, as applicable.
• Complete template forms summarizing patient-level benefits coverage determinations.
• Coordinate prior authorizations in accordance with payer guidelines and applicable laws, regulations, and guidance.
• Review patient assistance enrollment forms and supporting documentation to assess eligibility under SOPs and program guidelines.
• Determine patient eligibility based on program qualification criteria and communicate eligibility to patients, healthcare providers, and/or consignment pharmacies.
• Answer inbound callers and assist them through resolution using frequently asked questions or warm transfers to appropriate individuals.
• Listen to customers, assess their needs, and respond with patience and courtesy.
• Identify missing or incorrect information in program service requests and applications.
• Report adverse events and product complaint inquiries in accordance with SOPs and good manufacturer practices.
• Provide timely feedback to the company about service failures and customer concerns.
• Use PharmaCord Lynk to process claims and maintain workflow progress.
• Communicate case status to medical practice accounts and sales representatives, and provide consultative support on overcoming obstacles to paid therapy.
• Maintain a patient-focused approach and comply with company policies and procedures.
• Use Valeris’ values to support team success.
• Complete training on corporate policies and procedures by required deadlines.
• Follow SOPs consistently.
• Perform additional tasks or projects as assigned.

Benefits

• 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 a 100% match on the first 5% contributed and immediate vesting.
• Paid Time Off (PTO) and Sick Leave.
• Nine paid holidays plus two floating holidays.
• Opportunities for advancement and personal and professional growth.
• A challenging, stimulating work environment that encourages new ideas.
• An inclusive, mission-driven culture that values diversity and meaningful impact.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED