Field-Based Patient Access & Reimbursement Specialist

MSCCN; Chicago (IL); On-site; USD 164,000 - 222,000; Full time

Job summary

Amgen, a global biotechnology leader, seeks a Patient Access Liaison (PAL) to support patients, caregivers, and providers in navigating insurance coverage for Amgen therapies. This field-based role collaborates with Market Access, Medical Affairs, Advocacy, and Site of Care teams to enable timely access.

The PAL educates on prior authorization, co-pay assistance, and billing considerations while managing assigned patient cases with independence.

Qualifications

• Experience supporting buy-and-bill or infused therapies.
• Rare disease or orphan drug experience.
• Clinical background such as nursing or allied health.
• Understanding of prior authorization, appeals, and denied claims management.
• HIPAA guidelines and FDA regulatory knowledge.
• Familiarity with compliance guidelines (OIG and internal).
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to manage complex patient situations and resolve access barriers.
• Experience in cross-functional field teams.
• Proficiency in Microsoft Office, CRM, and related systems.
• Access and reimbursement knowledge.
• Prior authorization processes.
• Healthcare reimbursement systems.
• Coding and billing awareness.
• Patient support program knowledge.
• Compliance and privacy requirements.
• Learning agility and decision quality.
• Stakeholder engagement.
• Ability to respond rapidly to urgent access needs.
• Ability to operate in matrix field environments.

Responsibilities

• Patient Access and Reimbursement Support for infused therapies.
• Assist patients, caregivers, and providers with insurance benefits and prior authorizations.
• Support resolution of access barriers and denied claims.
• Educate on coding and billing considerations for therapy access.
• Develop relationships with patients and caregivers via phone, virtual, and in-person engagement.
• Obtain HIPAA authorization within assigned geography.
• Assess patient needs and provide education and resources for access to therapy.
• Educate on coverage considerations and steps for prior authorization.
• Provide information on co-pay programs, national foundations, and free drug programs.
• Educate physician offices and sites of care on coverage pathways and reimbursement processes.
• Provide information on prior authorization, coding, and billing considerations.
• Support providers in navigating reimbursement questions related to patient cases.
• Investigate access challenges before and after infusion.
• Escalate complex reimbursement issues to internal stakeholders.
• Partner with Market Access, Medical Affairs, Advocacy, Case Managers, Site of Care teams.
• Coordinate with partners to ensure resources for patient access.
• Share field insights on payer policies and reimbursement challenges.
• Adhere to policies, HIPAA, and compliance guidelines; document activities in Amgen systems.

Skills

Buy-and-bill experience

Orphan drug experience

Clinical background

HIPAA compliance knowledge

Strong communication skills

Cross-functional collaboration

Solution-oriented problem solving

Microsoft Office / CRM proficiency

Prior authorization knowledge

Healthcare reimbursement knowledge

Coding and billing awareness

Travel readiness (up to 50%)

Education

Doctorate degree

Master’s degree

Bachelor’s degree

Associate’s degree

High school diploma

Tools

Microsoft Office

CRM systems

Job description

Amgen, a global biotechnology leader, seeks a Patient Access Liaison (PAL) to support patients, caregivers, and providers in navigating insurance coverage for Amgen therapies. This field-based role collaborates with Market Access, Medical Affairs, Advocacy, and Site of Care teams to enable timely access.

The PAL educates on prior authorization, co-pay assistance, and billing considerations while managing assigned patient cases with independence.