Patient Access & Reimbursement Specialist

Inizio Engage; United States; On-site; USD 38,000 - 70,000; Full time

Benefits offered by this job

Competitive pay

Medical insurance

Dental and vision coverage

401(k) with company match

Paid maternity and paternity leave

Company-paid holidays

Career development

Job summary

Inizio Engage seeks a skilled patient access and reimbursement specialist to support a leading biotechnology product launch. You will manage patient cases from referral to initiation, conduct benefits investigations, and handle prior authorizations while ensuring compliance with HIPAA and SOPs.

The role requires strong communication, attention to detail, and the ability to navigate payer requirements, patient assistance programs, and cross-functional collaboration to drive timely therapy

Qualifications

• Bachelor’s Degree or equivalent experience preferred.
• Experience in patient access, HUB services, reimbursement support, specialty pharmacy, or healthcare case management preferred.
• Knowledge of benefits investigation, prior authorization, appeals, and patient assistance programs.
• Strong communication and interpersonal skills with a patient-focused approach.
• Ability to manage a high volume of cases in a fast-paced environment while meeting service level expectations.

Responsibilities

• Manage assigned patient cases from referral through therapy initiation, ensuring timely, accurate, and compliant case progression.
• Conduct benefits investigations electronically or by calling the insurance company to determine coverage information, prior authorization requirements, and patient financial responsibility.
• Manage the prior authorization and appeals process, including obtaining plan-specific criteria and requirements, initiating, submitting, and tracking requests, and following up with plans, patients, and HCPs as needed to ensure timely outcomes.
• Identify and facilitate patient enrollment in financial assistance programs, including copay and patient assistance programs.
• Support communications with patients, healthcare providers, payers, and specialty pharmacies as needed.
• Provide education on insurance coverage, access pathways, and next steps in the treatment journey when needed.
• Collaborate with internal teams and external partners to ensure timely therapy initiation and adherence to service level agreements.
• Document all case activity accurately within HUB systems in compliance with SOPs and regulatory requirements.
• Monitor case progress and elevate complex reimbursement issues as needed.
• Response to incoming calls from patients/caregivers and prescriber’s offices and addressing or routing calls as needed.
• Support leadership with tracking and resolving escalations.
• Support quality initiatives, audits, and continuous process improvement efforts.
• Ensure compliance with HIPAA, privacy, and regulatory standards at all times.

Skills

Case management

Benefits investigations

Prior authorization

Patient enrollment

Communication skills

CRM systems

Microsoft Office

HIPAA compliance

Education

Bachelor’s degree or equivalent

Tools

Job description

Inizio Engage seeks a skilled patient access and reimbursement specialist to support a leading biotechnology product launch. You will manage patient cases from referral to initiation, conduct benefits investigations, and handle prior authorizations while ensuring compliance with HIPAA and SOPs.

The role requires strong communication, attention to detail, and the ability to navigate payer requirements, patient assistance programs, and cross-functional collaboration to drive timely therapy