Role Description
oin Amgen’s Mission of Serving Patients. The Patient Access Liaison (PAL) is a field-based patient access and reimbursement specialist responsible for supporting patients, caregivers, healthcare providers, and sites of care in navigating insurance coverage and reimbursement pathways for Amgen therapies.
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Serve as a resource on patient access and reimbursement for infused and specialty therapies.
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Assist patients, caregivers, and healthcare providers in navigating insurance benefits, prior authorization requirements, and reimbursement processes.
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Support the identification and resolution of access challenges, including coverage questions, prior authorization barriers, and denied claims.
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Provide education regarding coding and billing considerations relevant to therapy access.
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Develop relationships with patients and caregivers through phone, virtual, and in-person engagement.
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Secure written or electronic patient HIPAA authorization within assigned geography.
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Assess individual patient needs and provide education and resources that support access to therapy.
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Educate patients on coverage considerations and the steps required to obtain prior authorization.
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Provide information regarding co-pay assistance programs, national foundations, and free drug programs when appropriate.
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Educate physician offices and sites of care on therapy coverage pathways and reimbursement processes.
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Provide information regarding common prior authorization requirements, coding considerations, and billing practices.
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Support healthcare providers and infusion centers in navigating reimbursement questions related to patient cases.
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Investigate patient access challenges before and after infusion.
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Support physician offices and sites of care in reviewing denied claims and identifying potential next steps.
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Escalate complex or systemic reimbursement issues to appropriate internal stakeholders.
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Partner with internal stakeholders including Market Access, Medical Affairs, Advocacy, Case Managers, and Site of Care teams to support patient access initiatives.
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Coordinate with internal and external partners to ensure appropriate resources are available to support patient access.
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Share field insights regarding payer policies and reimbursement challenges.
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Adhere to company policies, compliance guidance, and applicable federal, state, and local regulations.
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Ensure activities align with HIPAA privacy requirements and internal compliance guidelines.
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Report adverse events and product complaints through established pharmacovigilance processes.
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Maintain accurate documentation of activities and interactions in Amgen’s internal system.
Qualifications
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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.
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Doctorate degree and 2 years of patient services, and/or access and reimbursement, experience OR Master’s degree and 4 years of patient services, and/or access and reimbursement, experience OR Bachelor’s degree and 6 years of patient services, and/or access and reimbursement, experience.
Requirements
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Experience supporting buy-and-bill or infused pharmaceutical therapies.
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Rare disease or orphan drug experience.
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Clinical background such as nursing or allied health.
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Understanding of reimbursement processes including prior authorization, appeals, and denied claims management.
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Knowledge of HIPAA guidelines and FDA regulatory requirements.
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Familiarity with internal and OIG compliance guidelines.
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Strong analytical and problem-solving skills.
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Excellent written and verbal communication skills.
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Ability to manage complex patient situations and resolve access barriers.
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Experience working in cross-functional field teams.
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Proficiency in Microsoft Office, CRM, AI and relevant systems.
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Access and reimbursement knowledge.
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Prior authorization processes.
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Healthcare reimbursement systems.
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Coding and billing awareness.
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Patient support program knowledge.
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Compliance and privacy requirements.
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Learning agility.
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Decision quality.
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Stakeholder engagement.
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Ability to respond rapidly to urgent access needs to prevent treatment delays or lapses.
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Ability to operate effectively in matrix field environments.
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Travel up to 50%, including occasional overnight and weekend commitments.
Benefits
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The annual base salary range is from $158,394 - $185,578 for Level 5, $164,276 - $222,256 for Level 6.
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Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts.
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A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan.
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Stock-based long-term incentives.
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Award-winning time-off plans and bi-annual company-wide shutdowns.
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Flexible work models, including remote work arrangements, where possible.