Sr. Patient Navigator

Valeris•Remote, North Carolina, NC

48d

About The Position

The Sr. Patient Navigator helps patients access life-altering medications by guiding them through complex processes such as insurance verification, prior authorizations, and appeals. The position combines customer service, relationship management, and reimbursement expertise to provide personalized support while ensuring compliance with healthcare regulations. The role also educates healthcare providers and patients about access, coverage, and reimbursement support, and is regionally aligned to support patients. Available schedules are 9 a.m.–6 p.m., 10 a.m.–7 p.m., or 11 a.m.–8 p.m. Eastern Time, Monday through Friday. Travel may be required a few times per quarter at the client’s request, to the Valeris headquarters closest to the selected candidate in Morrisville, North Carolina, or Jeffersonville, Indiana. The position operates in a professional office environment and routinely uses standard office equipment. The employee is regularly required to talk or hear and frequently required to sit for long periods, use hands to type, handle, or feel, and reach with hands and arms. Candidates who can type at least 35 words per minute with 97% accuracy are preferred. Full-time employees are offered health and other benefits, paid leave and holidays, and opportunities for personal and professional growth. Employment offers are contingent upon successful completion of a background check and, depending on the position, a drug screen. Duties and responsibilities may be modified at any time.

Requirements

Bachelor’s degree required; preferably in healthcare administration, social science, or a related field.
In lieu of a degree, 5–10 years of relevant experience in insurance reimbursement, patient access, direct patient care, or patient education may qualify.
Alternatively, relevant certification such as PACS, CHES, or CCM plus at least five consecutive years of related experience may qualify in lieu of a degree.
Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
Ability to prioritize tasks and work efficiently in a fast-paced environment.
Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.

Nice To Haves

At least two years of experience in healthcare access delivery or management is strongly preferred.
Bilingual or multilingual ability is a plus.
Flexibility to travel as needed is preferred, although travel is described as very minimal.
Typing ability of at least 35 words per minute with 97% accuracy is preferred.

Responsibilities

Serve as the single point of contact and provide personalized case management for patients, caregivers, and healthcare providers, including benefit investigations, prior authorization tracking, and appeal support.
Educate patients, healthcare providers, and stakeholders on access and reimbursement processes, payer policies, and Valeris programs, including patient assistance and copay programs.
Build and maintain trusted relationships with patients, prescribers, and client stakeholders by providing accurate, timely, and compassionate support.
Coordinate and collaborate with client field teams while following agreed business rules and guidelines.
Explain benefit coverage options and next steps in the patient journey using clear, patient-friendly language.
Use electronic tools to complete benefit investigations and help secure payer coverage for prescribed treatments.
Ensure activities comply with healthcare laws, regulations, and Valeris standard operating procedures, including HIPAA and insurance guidelines.
Identify and escalate adverse events, product complaints, and special situation reports as required by the program.
Document all activities in the Valeris system and maintain detailed, accurate records.
Support adherence services, including patient education and coordination of nurse teaching when applicable.
Participate in team meetings and ongoing training to stay current on policies and procedures.
Use Valeris’ values to guide the team’s success.
Complete training on corporate policies and procedures on time.
Follow all standard operating procedures 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 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 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 workplace that values diversity.
A mission-driven, inclusive culture where work can make a meaningful impact.