Sr. Reimbursement Specialist - Patient Access Services Hub
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Reimbursement Specialist - Patient Access Services Hub based in United States.
This role sits at the center of patient access and healthcare reimbursement, ensuring patients can obtain timely access to prescribed therapies while navigating complex insurance and pharmacy processes. The Sr. Reimbursement Specialist acts as a critical liaison between patients, healthcare providers, insurers, and pharmacies to coordinate benefits, prior authorizations, and product delivery. You will play a key role in improving treatment accessibility and supporting patient outcomes through accurate case management and proactive communication. The environment is fast-paced, detail-driven, and highly collaborative, requiring strong coordination across multiple stakeholders. You will also contribute to compliance reporting, adverse event tracking, and education of external partners on program requirements. This is a meaningful opportunity for a healthcare professional who thrives in service-oriented, impact-driven roles within the pharmaceutical support ecosystem.
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Reimbursement Specialist - Patient Access Services Hub based in United States.
This role sits at the center of patient access and healthcare reimbursement, ensuring patients can obtain timely access to prescribed therapies while navigating complex insurance and pharmacy processes. The Sr. Reimbursement Specialist acts as a critical liaison between patients, healthcare providers, insurers, and pharmacies to coordinate benefits, prior authorizations, and product delivery. You will play a key role in improving treatment accessibility and supporting patient outcomes through accurate case management and proactive communication. The environment is fast-paced, detail-driven, and highly collaborative, requiring strong coordination across multiple stakeholders. You will also contribute to compliance reporting, adverse event tracking, and education of external partners on program requirements. This is a meaningful opportunity for a healthcare professional who thrives in service-oriented, impact-driven roles within the pharmaceutical support ecosystem.
Accountabilities:
- Conduct benefit investigations and insurance verification for patients and healthcare providers, ensuring accurate assessment of coverage and reimbursement eligibility.
- Manage prior authorizations and recertifications, working closely with payers to secure timely approvals and continued treatment coverage.
- Maintain accurate and complete patient case files within internal databases, tracking outstanding actions and ensuring data integrity across all records.
- Coordinate product ordering, shipment, and therapy initiation by liaising with pharmacies, prescribers, and patients.
- Handle inbound call center activities, triaging inquiries from patients, insurers, providers, and pharmacies while serving as a primary point of contact for assigned accounts.
- Identify and report adverse events, product quality issues, and other required compliance events in accordance with regulatory standards.
- Educate stakeholders on program processes and requirements to ensure smooth patient access and adherence to guidelines.
- High school diploma or GED required; additional education or relevant healthcare experience preferred.
- 4–6 years of experience in insurance, biotechnology, pharmaceutical services, reimbursement, or patient support services.
- Strong knowledge of insurance claims processes, third-party billing, prior authorizations, and appeals is highly preferred.
- Proficiency in Microsoft Office tools and experience working with databases or case management systems.
- Excellent written and verbal communication skills with the ability to engage effectively with patients, providers, and payers.
- Strong attention to detail, analytical thinking, and ability to manage multiple priorities in a fast-paced environment.
- Familiarity with medical terminology and healthcare reimbursement workflows is a strong advantage.
- Remote work opportunities within the United States
- Competitive salary with performance-based growth potential
- 401(k) plan with company match
- Comprehensive medical, dental, and vision insurance
- Health Savings Account (HSA) and Flexible Spending Account (FSA) options
- Paid time off, paid holidays, and flexible work arrangements
- Tuition reimbursement and professional development support
- Employee assistance program and wellness initiatives, including telemedicine access
- Short-term and long-term disability coverage and life insurance
- Adoption assistance and family support programs
- Additional employee discount programs and well-being resources
Requirements:
Benefits: