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Inizio Engage · 1 day ago

Virtual Access and Reimbursement Manager

United States

Full-time

Remote

Mid Level

3+ years exp

Inizio Engage is a strategic engagement partner specializing in healthcare. The Virtual Access and Reimbursement Manager will educate healthcare providers on product-specific prior authorization and appeals processes while collaborating with various teams to ensure compliance and effective communication.

CommercialHealth CareHospital

Responsibilities

Virtually engage with HCPs and appropriate office staff about product specific prior authorization & appeals process, how to access related forms, and high-level information about submission procedures and reauthorization requirements

Work with in-network Specialty Pharmacies on cases where the patient has provided consent

Educate HCPs and appropriate office staff on specific referral processes and patient assistance programs

Utilize approved resources and FAQs to provide education and answer questions as needed

Solid understanding of reimbursement issues that work within our core classes of trade: Commercial Managed Care (Regional Plans), Medicaid (Fee for Service, Managed Care Organizations), Medicare (Part A, B, C, D; Carriers), Veteran’s Administration (VISNs), TRICARE Regional Offices, Specialty Pharmacy & Pharmacy Benefit Managers, ACOs and other Integrated Delivery Networks (IDNs), Advocacy, consumer, provider and treatment systems groups

Document call details within CRM with attention to data integrity to ensure compliance with program policies and business rules

Maintain confidentiality of Patient Health Information (PHI) and act in compliance with all laws, regulations, and company policies

Adhere to all Inizio and client policies, procedures, business rules, and call guides, as well as applicable laws

Qualification

Reimbursement knowledgePatient access experienceVirtual engagement skillsSpecialty pharmacy experiencePayer reimbursement modelsMulti-tasking abilityAttention to detailCommunication skillsOrganizational skills

Required

BS/BA Degree

3+ years of relevant experience in – reimbursement and patient access, market access, specialty pharmacy, or physician/system account management

Proven success operating in a virtual environment

Strong knowledge and understanding of payer reimbursement models (medical and pharmacy), prior authorization and appeal requirements, coding changes, appropriate claim submission, integration of HUB and patient assistance programs

Maintains compliance with program business rules, standard operating procedures and guidelines

Highly organized with excellent attention to detail and the ability to multi-task in engaging both patients and providers

Passionate about learning and able to share/communicate that passion to others

Experience engaging HCP staff in a support role to educate on access pathways and product requirements

Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and coverage policy)

Preferred

Experience in endocrine or men's health disorders preferred

Benefits

Competitive compensation

Excellent Benefits – accrued time off, medical, dental, vision, 401k, disability & life insurance, paid maternity and paternity leave benefits, employee discounts/promotions

Employee discounts & exclusive promotions

Recognition programs, contests, and company-wide awards

Exceptional, collaborative culture

Best Places to Work in BioPharma (2022, 2023, & 2024)

Certified Great Place to Work (2022, 2023, 2025)