Sr. Patient Access Representative

POSITION SUMMARY: The Sr. Patient Access Representative provides day-to-day oversight and workflow support for frontline Benefits Verification (BV) and Prior Authorization (PA) staff while performing complex quality audits. This role helps ensure benefit investigations, authorization submissions, and recurring authorization activities are accurate, timely, complete, and compliant with payer requirements. The Sr. Patient Access Representative serves as a frontline resource for questions and escalations, identifies reimbursement risks, coaches staff on audit findings, and partners with Admissions, Audit, Accounts Receivable, and other teams to prevent avoidable delays and denials.

ESSENTIAL DUTIES: Provide day-to-day oversight for frontline BV and PA staff, including work assignment, queue monitoring, coverage coordination, productivity follow-up, and support with questions. Perform routine and complex audits of benefit investigations, prior authorization submissions, recurring authorizations, approvals, denials, and supporting documentation to confirm accuracy and payer complianceCoach staff on audit findings, deliver timely feedback, support onboarding and ongoing training, and identify recurring knowledge or process gaps for leadership..Serve as the first point of escalation for complex or urgent BV and PA issues; research payer requirements and coordinate resolution with Admissions leadership, Audit, Accounts Receivable, clinical teams, and other partnersTrack audit results, turnaround times, work quality, trends, and outstanding issues; provide clear updates and recommendations to the Admissions Sr. Manager. Support process improvement, standard work, policy updates, and readiness for new therapies or payer changes. Perform other duties or projects as assigned. Careers with real impact. Every role at Orsini moves a patient closer to life-changing therapy. We partner with biopharma innovators, healthcare providers, and payers to make access simple, compassionate, and reliable - so no patient is left behind. Make your next role matter. ABOUT ORSINIProviding compassionate care since 1987, Orsini is a leader in rare disease and gene therapy pharmacy solutions, built to simplify how patients connect to advanced medicines. Through our comprehensive commercialization solutions including a nationwide specialty pharmacy, patient services hub, home infusion and nursing network, and third-party logistics provider, we work with biopharma, providers, and payors to ensure No Patient is Left Behind™.OUR MISSIONOrsini is on a mission to be the essential partner for biopharma innovators, healthcare providers, and payers to support patients and their families in accessing revolutionary treatments for rare diseases. Through our integrated portfolio of services, we seek to pioneer comprehensive solutions that simplify how patients connect to advanced therapies while providing holistic, compassionate care so that No Patient is Left Behind™.CORE VALUESAt the heart of our company culture, the Orsini LIVE IT Core Values serve as guiding principles that shape how we interact with each other and those we serve. These values are the driving force behind our commitment to excellence, collaboration, and genuine care in every aspect of our work. COMPENSATION The compensation for this position is $25 per/hour.

POSITION SUMMARY: The Sr. Patient Access Representative provides day-to-day oversight and workflow support for frontline Benefits Verification (BV) and Prior Authorization (PA) staff while performing complex quality audits. This role helps ensure benefit investigations, authorization submissions, and recurring authorization activities are accurate, timely, complete, and compliant with payer requirements. The Sr. Patient Access Representative serves as a frontline resource for questions and escalations, identifies reimbursement risks, coaches staff on audit findings, and partners with Admissions, Audit, Accounts Receivable, and other teams to prevent avoidable delays and denials.

ESSENTIAL DUTIES: Provide day-to-day oversight for frontline BV and PA staff, including work assignment, queue monitoring, coverage coordination, productivity follow-up, and support with questions. Perform routine and complex audits of benefit investigations, prior authorization submissions, recurring authorizations, approvals, denials, and supporting documentation to confirm accuracy and payer complianceCoach staff on audit findings, deliver timely feedback, support onboarding and ongoing training, and identify recurring knowledge or process gaps for leadership..Serve as the first point of escalation for complex or urgent BV and PA issues; research payer requirements and coordinate resolution with Admissions leadership, Audit, Accounts Receivable, clinical teams, and other partnersTrack audit results, turnaround times, work quality, trends, and outstanding issues; provide clear updates and recommendations to the Admissions Sr. Manager. Support process improvement, standard work, policy updates, and readiness for new therapies or payer changes. Perform other duties or projects as assigned.

Disclaimer: The information written in this job description indicates the general nature and level of work to be performed. This job description is not designed to contain or be interpreted as totally comprehensive of every job duty, responsibility, or qualification required by an employee assigned to this job. While employed in this position, an employee may be required to perform other assignments not listed in this job description. SKILLS & COMPETENCIESHigh school diploma or equivalent from an accredited school required; associate or bachelor degree preferred. Minimum 3 years of related specialty pharmacy, benefits verification, prior authorization, reimbursement, or major medical insurance experience preferred. Demonstrated ability to lead daily work, support staff, provide constructive feedback, and reinforce performance expectations. Strong knowledge of major medical benefits, Medicare, Medicaid, commercial payer requirements, and policy interpretation. Working knowledge of prior authorization requirements, authorization date spans, prescription-based unit calculations, and documentation standards. Ability to audit work objectively, identify root causes and reimbursement risk, and communicate clear corrective action. Strong organizational, analytical, written, and verbal communication skills. Ability to prioritize competing work in a fast-paced environment and manage urgent patient or payer escalations. Must be highly detail oriented and able to handle protected health information in accordance with HIPAA requirements.

EMPLOYEE BENEFITS: We offer a comprehensive benefits package designed to support your health, financial security, and overall well-being: Medical Coverage, Dental, and Vision Coverage 401(k) with employer match Accident and Critical Illness coverage Company-paid life insurance options Generous PTO, paid holidays, and floating holidays Tuition reimbursement program. Equal Employment Opportunity Orsini Rare Disease Pharmacy Solutions is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or present or past disability (unless the nature and extent of the disability precludes performance of the essential functions of the job with or without a reasonable accommodation) in accordance with local, state and federal laws. Americans with Disabilities ActApplicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law. E-Verify Participation NoticeWe participate in the federal E-Verify program to confirm the identity and employment eligibility of all newly hired employees. All offers of employment are contingent upon the successful completion of Form I-9 and verification through the E-Verify system. For more information about E-Verify, please review the official notices below: E-Verify Participation Poster (English & Spanish): https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdfRight to Work Poster (English & Spanish): https://www.e-verify.gov/sites/default/files/everify/posters/IER_RightToWorkPoster.pdf