Bilingual Spanish/English Benefit Specialist

About the role

The Bilingual Spanish/English Benefit Specialist plays a crucial role in improving patient access to critical medications. You will work directly with patients, healthcare providers, and insurance companies to verify benefits, determine coverage, and manage patient assistance programs.

Responsibilities

• Perform patient-level benefits verifications for all major medical and pharmacy benefits plans.
• Complete template forms providing patient-level benefits coverage determinations.
• Coordinate prior authorizations based on payer guidelines and legal requirements.
• Assess and communicate patient eligibility for patient assistance programs.
• Answer and assist inbound callers, addressing their inquiries and transferring calls as necessary.
• Identify and correct missing or incorrect information in program service requests and applications.
• Report adverse events and product complaints in accordance with SOPs and good manufacturing practices.
• Provide timely feedback to the company regarding service failures or customer concerns.
• Utilize Valeris' internal technology platform, Lynk, to process claims and maintain workflow efficiency.
• Communicate with key medical practice accounts and sales representatives to update case statuses.
• Offer consultative services to resolve issues and ensure patients are on paid therapy.

Qualifications

• Bachelor's degree preferred; high school diploma or GED required.
• At least 6 months of customer service experience, preferably in a healthcare setting.
• Experience with payer benefits, reimbursement, prior authorization, and healthcare industry knowledge is preferred.
• Spanish/English bilingualism is required.

Physical Demands & Work Environment

This role requires regular sitting for extended periods, typing, handling documents, and reaching with hands and arms. Candidates should be able to type at least 35 words per minute with 97% accuracy. Minimal travel may be required.

Benefits

• Medical, dental, and vision plans with HSA- and FSA-eligible options, with Valeris contributing to premiums.
• Telehealth and Employee Assistance Program (EAP) services.
• Health savings account (HSA) and flexible spending account (FSA) contributions.
• Short-term and long-term disability coverage.
• Retirement savings plan with a 100% match on the first 5% contributed.
• Paid time off (PTO) and sick leave.
• Nine paid holidays plus two floating holidays.
• Opportunities for advancement and professional growth.

Equal Opportunity Employer

We are committed to creating an inclusive workplace where diversity is celebrated and valued. Valeris is an equal opportunity employer and does not discriminate against applicants based on race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by law.