Benefit Specialist

As a Benefits Specialist at Valeris, you will provide in‑depth knowledge of client programs by working directly with patients, healthcare providers, and insurance companies to answer inquiries, process service requests, assess benefits coverage, and manage barriers to patient access to therapy. The role is a dynamic, compassionate customer‑service position delivered via telephone and web‑based channels. Key Responsibilities Benefit Verification: Perform patient‑level benefit verifications for all major medical and pharmacy benefit plans and complete template forms providing patient‑level benefit coverage determination summaries. Prior Authorization Coordination: Coordinate prior authorizations based on payer guidelines and in compliance with law, regulation, or guidance. Patient Assistance: Review patient assistance enrollment forms and supporting documentation to assess eligibility per SOPs and program guidelines and determine patient eligibility based on program criteria. Communications: Inform patients, healthcare providers, and consent pharmacy of eligibility; answer inbound calls, resolve inquiries using FAQs or warm transfer to appropriate personnel. Application Review: Identify missing or incorrect information within program service requests/applications. Adverse Event & Product Complaint Reporting: Report inquiries in accordance with SOP and good manufacturer practices. Feedback: Provide timely feedback regarding service failures or customer concerns. Technology Use: Use PharmaCord Lynk to complete claims processing and maintain workflows. Account Communication: Communicate with key medical practice accounts and sales representatives regarding case status. Consultative Support: Provide consultative services to overcome obstacles enabling patients to receive paid therapy. Compliance & SOPs: Adhere to Valeris values, training deadlines, SOPs, and perform additional tasks or projects as assigned. Qualifications Service‑minded focus on meeting the needs of patients and care partners. Ability to handle personal health information with confidentiality. Commitment to honesty, integrity, professionalism, and proper business and customer‑service etiquette. Clear verbal and written communication skills. Accountability for results, strong planning, prioritization, and attention to detail. Proficient emotional intelligence and ability to manage disruptive impulses and stressful interactions. Proficient computer skills and adaptability to change. Personal initiative, team orientation, and positive attitude. Bachelor’s degree strongly preferred; high school diploma or GED required. At least 6 months of customer service experience with payer benefits (reimbursement, prior authorization, etc.), healthcare industry experience, or related certification/licensure preferred. Bilingual language skills considered a plus. Physical Demands & Work Environment The position requires regular speaking/hearing, sitting for extended periods, typing, handling equipment, and occasional travel. Candidates should be able to type at least 35 words per minute with 97% accuracy. Benefits Medical, dental, and vision plans including HSA‑ and FSA‑eligible options with Valeris contributing toward premiums. Health support including 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 (minimum$50,000, maximum$300,000). Company‑paid Short‑Term Disability and optional Long‑Term Disability coverage. 401(k) retirement savings plan with 100% match on first 5% contributed, immediate vesting. Paid Time Off (PTO) and Sick Leave, nine paid holidays plus two floating holidays. Opportunities for advancement and a challenging, stimulating work environment. Diversity and inclusion commitment and a mission‑driven culture. Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Our Commitment to Equal Opportunity Valeris is proud to be an equal opportunity employer. We celebrate differences, support diversity, and create an inclusive workplace. All qualified applicants will receive equal consideration for employment. #J-18808-Ljbffr