Medical Billing Representative
PharmaCord, Jeffersonville, IN, United States
Valeris Commercialization Specialist
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana.
Key Responsibilities:
Assist with determining coverage and access options available for a specific medication or procedure
Collect and analyze information and resources related to local, regional or national payer coverage or claim submission process
Clearly articulate complex reimbursement and billing information to HCPs, their office staff and/or patients to ensure understanding of coverage benefit and financial responsibility
Educate provider offices on local and regional payer coverage policies, issues, coding changes, and appropriate claims submission processes
Educate offices about the medical necessity requirements for coverage and provide education support for the office to submit pre-determinations, appeals and/or peer to peer reviews with payors, as applicable
Assist offices to understand payor denied or underpaid claims and provide education, as applicable, for the office to resolve of rejected, denied or underpaid claims
Educate HCPs, their office staff and/or patients on appropriate resources for questions about co-pay, coinsurance, out of pocket costs, deductibles and other financial assistance or coverage related questions
Serve as a patient advocate and enhance the customer experience for all callers by acting as a single point of contact and a compassionate voice for all providers and patients
Utilize Valeris' values as the driving force behind the team's success
On time adherence to training deadlines for all corporate policies and procedures
Ensure all SOPs are followed with consistency
Perform additional tasks or projects as assigned
Qualifications:
Detail oriented
Professional telephone etiquette
Basic computer knowledge
Ability to multitask effectively
Ability to recognize emotions and their effects
Sureness about self-worth and capabilities
Manage disruptive impulses
Maintain standards of honesty and integrity
Take responsibility for performance
Be adaptable and handle change with flexibility
Be innovative and open to new ideas
Achievement driven; constant striving to improve or to meet a standard of excellence
Align with the goals of the group or organization
Ready to take initiative and act on opportunities
Be optimistic and pursue goals persistently despite obstacles and setbacks
Be service oriented and anticipate, recognize and meet needs of others, including patients and care partners
Communicate clearly and send clear messages
Ability to consume complex coverage policy changes and convert complexity to educate lay persons
Adaptability to change
Personal initiative and commitment to team and organizational goals
Ability to work effectively within a team
A positive attitude!
Minimum of (two) 2 years' of billing and coding experience is preferred
Bachelor's degree in arts and sciences, social work, public health administration or a related field preferred
Billing and coding diploma or certificate strongly preferred
High School diploma or equivalent is required
Strong understanding of medical terminology background is preferred
Background working directly within physician practices or outpatient clinics billing commercial insurances, Medicare, and Medicaid preferred
Bi-lingual in English and Spanish or Chinese/Mandarin is a plus
Physical Demands & Work Environment:
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We're committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
Additional 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 your 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% you contribute, with immediate vesting
Paid Time Off (PTO) and Sick Leave to support work-life balance
Team members receive nine paid holidays plus two floating holidays
Opportunities for advancement in a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
A mission-driven, inclusive culture where your work makes a meaningful impact
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 At Valeris, we don't just accept difference we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
Important Notice
Due to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official @valeris.com and/or @echo.newtonsoftware.com email address regarding next steps in our interview process.
Please Note:
PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @valeris.com or @echo.newtonsoftware.com email address, or through our scheduling platform, Calendly.
We will never request your bank account information at any stage of the hiring process.
We will never send a check (electronic or physical) to purchase home office equipment.
If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@valeris.com
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana.
Key Responsibilities:
Assist with determining coverage and access options available for a specific medication or procedure
Collect and analyze information and resources related to local, regional or national payer coverage or claim submission process
Clearly articulate complex reimbursement and billing information to HCPs, their office staff and/or patients to ensure understanding of coverage benefit and financial responsibility
Educate provider offices on local and regional payer coverage policies, issues, coding changes, and appropriate claims submission processes
Educate offices about the medical necessity requirements for coverage and provide education support for the office to submit pre-determinations, appeals and/or peer to peer reviews with payors, as applicable
Assist offices to understand payor denied or underpaid claims and provide education, as applicable, for the office to resolve of rejected, denied or underpaid claims
Educate HCPs, their office staff and/or patients on appropriate resources for questions about co-pay, coinsurance, out of pocket costs, deductibles and other financial assistance or coverage related questions
Serve as a patient advocate and enhance the customer experience for all callers by acting as a single point of contact and a compassionate voice for all providers and patients
Utilize Valeris' values as the driving force behind the team's success
On time adherence to training deadlines for all corporate policies and procedures
Ensure all SOPs are followed with consistency
Perform additional tasks or projects as assigned
Qualifications:
Detail oriented
Professional telephone etiquette
Basic computer knowledge
Ability to multitask effectively
Ability to recognize emotions and their effects
Sureness about self-worth and capabilities
Manage disruptive impulses
Maintain standards of honesty and integrity
Take responsibility for performance
Be adaptable and handle change with flexibility
Be innovative and open to new ideas
Achievement driven; constant striving to improve or to meet a standard of excellence
Align with the goals of the group or organization
Ready to take initiative and act on opportunities
Be optimistic and pursue goals persistently despite obstacles and setbacks
Be service oriented and anticipate, recognize and meet needs of others, including patients and care partners
Communicate clearly and send clear messages
Ability to consume complex coverage policy changes and convert complexity to educate lay persons
Adaptability to change
Personal initiative and commitment to team and organizational goals
Ability to work effectively within a team
A positive attitude!
Minimum of (two) 2 years' of billing and coding experience is preferred
Bachelor's degree in arts and sciences, social work, public health administration or a related field preferred
Billing and coding diploma or certificate strongly preferred
High School diploma or equivalent is required
Strong understanding of medical terminology background is preferred
Background working directly within physician practices or outpatient clinics billing commercial insurances, Medicare, and Medicaid preferred
Bi-lingual in English and Spanish or Chinese/Mandarin is a plus
Physical Demands & Work Environment:
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We're committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
Additional 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 your 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% you contribute, with immediate vesting
Paid Time Off (PTO) and Sick Leave to support work-life balance
Team members receive nine paid holidays plus two floating holidays
Opportunities for advancement in a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
A mission-driven, inclusive culture where your work makes a meaningful impact
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 At Valeris, we don't just accept difference we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
Important Notice
Due to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official @valeris.com and/or @echo.newtonsoftware.com email address regarding next steps in our interview process.
Please Note:
PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @valeris.com or @echo.newtonsoftware.com email address, or through our scheduling platform, Calendly.
We will never request your bank account information at any stage of the hiring process.
We will never send a check (electronic or physical) to purchase home office equipment.
If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@valeris.com