Sr. Associate Insurance Reimbursement Associate – Team Lead - US Remote

Career Category

Value and Access

Job Description

HOW MIGHT YOU DEFY IMAGINATION?  

You’ve worked hard to become the professional you are today and are now ready to take the next step in your career. How will you put your skills, experience, and passion to work toward your goals? At Amgen, our shared mission—to serve patients—drives all that we do. It is key to our becoming one of the world’s leading biotechnology companies, reaching over 10 million patients worldwide. Come do your best work alongside other innovative, driven professionals in this meaningful role.  

If you feel like you’re part of something bigger, it’s because you are. At Amgen, our shared mission—to serve patients—drives all that we do. It is key to our becoming one of the world’s leading biotechnology companies. We are global collaborators who achieve together—researching, manufacturing, and delivering ever-better products that reach over 10 million patients worldwide. It’s time for a career you can be proud of. Join us!  

 

Sr. Associate Insurance Reimbursement Associate – Team Lead  

 

Live 

What you will do  

Let’s do this! Join an incredible team that’s redefining Amgen’s patient support programs. In this vital role, you will be handling industry leading transformation of our overall patient support offerings. This is a unique opportunity to work on a dynamic launch brand, gain portfolio product experience, and help build a new best-in-class patient support program from the ground up.  

Amgen is an innovative organization with a powerful sense of shared purpose toward our mission: to serve patients. Within Patient Access, we will provide you the capabilities, resources, and rewards of a global enterprise, entrepreneurialism and verve that marked our early days as a biotechnology pioneer. We encourage our team members to have fulfilling and significant careers through exciting assignments, career development, and valuable opportunities!  

 

Job Overview:  

Under the general direction of the HUB Manager, the Team Lead interfaces and works closely with the HCP office staff, Amgen Access Specialists (AAS), and payers to remove barriers and enable patients to start and/or continue therapy. The Team Lead understands program designs, coordinates with various insurance companies as well as health care professionals to facilitate the necessary and prescribed therapy for their patients.  

 

Key Responsibilities:  

In this vital role you will provide a high level of Denied Claims and Escalation support to internal and external business partners.  You will also provide benefit verification, prior authorization, and reimbursement information to customers in alignment with standard operating procedures.   

• Interpret medical and/or pharmacy insurance benefits as needed to customers 

• Provide support with provider portal and portal associated tasks, as needed 

• Assign cases to team to maintain agent workflow  

• Provide program-specific education to HCP office staff, healthcare professionals and both internal and external business partners  

• Communicate outcomes to customers  

• Research and resolve complex claim denials or underpayment of claims  

• Analyze and compile data regarding reimbursement trends to assist with continuous improvement efforts  

• Engage in reimbursement conversations with both commercial and government payors  

• Communicate with payors and HCP to ensure accuracy and timeliness 

• Providing timely status updates to Amgen Access Specialists (AAS), as well as health care professionals and office staff  

• Build positive internal and external working relationships with business partners  

• Subject Matter Expert (SME) responsible for providing task-specific training to team members and new hires, as necessary 

• Skilled at handling critical issues and maintains frequent contact with customers during the resolution processes for escalated cases 

• Reports all Adverse Events (AE) as required and aligned with training and Standard Operational Procedures (SOP) 

• Assists with the development of program training documents 

• Proven ability to positively influence team members to shift as the business needs change.  

• Assist team members resolve work-related issues (i.e. submit Pulse tickets, answer program questions, etc.) 

• Performs related duties as assigned 

 

Win  

What we expect of you  

We are all different, yet we all use our unique contributions to serve patients. The transformational professional we seek is an advocate with these qualifications.  

Basic Qualifications:  

• Master’s degree OR  

• Bache