Field Patient Access & Reimbursement Specialist

MSCCN; Houston (TX); On-site; USD 158,000 - 222,000; Full time

Job summary

Amgen seeks a Field-based Patient Access Liaison to support patients, caregivers, and providers in navigating insurance coverage and reimbursement pathways for Amgen therapies. You will address payer requirements, prior authorizations, and cost-support resources while collaborating with Market Access, Medical Affairs, Advocacy, Case Management, and Site of Care teams to advance patient access.

The role emphasizes independent management of patient cases, education on coverage considerations, and

Qualifications

• Doctorate degree; OR Master’s degree and 2 years of patient services and/or access and reimbursement experience; OR Bachelor’s degree and 4 years of patient services and/or access and reimbursement experience; OR Associate’s degree and 8 years of patient services and/or access and reimbursement experience; OR High school diploma / GED and 10 years of patient services and/or access and reimbursement experience.
• Experience supporting buy-and-bill or infused pharmaceutical therapies; Rare disease or orphan drug experience; Clinical background such as nursing or allied health; Understanding of reimbursement processes including prior authorization, appeals, and denied claims management; Knowledge of HIPAA guidelines and FDA regulatory requirements; Familiarity with internal and OIG compliance guidelines; Strong analytical and problem-solving skills; Excellent written and verbal communication skills; Ability to manage complex patient situations and resolve access barriers; Travel up to 50%, including occasional overnight and weekend commitments

Responsibilities

• Educate physician offices and sites of care on therapy coverage pathways and reimbursement processes.
• Provide information regarding common prior authorization requirements, coding considerations, and billing practices.
• Support healthcare providers and infusion centers in navigating reimbursement questions related to patient cases.
• Investigate patient access challenges before and after infusion.
• Escalate complex or systemic reimbursement issues to appropriate internal stakeholders.
• Coordinate with internal and external partners to ensure appropriate resources are available to support patient access.

Job description

Amgen seeks a Field-based Patient Access Liaison to support patients, caregivers, and providers in navigating insurance coverage and reimbursement pathways for Amgen therapies. You will address payer requirements, prior authorizations, and cost-support resources while collaborating with Market Access, Medical Affairs, Advocacy, Case Management, and Site of Care teams to advance patient access.

The role emphasizes independent management of patient cases, education on coverage considerations, and