Patient Access Case Management

Kerry Merisier

Case Management/Access Reimbursement

******.********@*****.***

www.linkedin.com/in/kerry-m-948669161

857-***-**** • Port Saint Lucie, FL 34984

Summary

Patient Access and Case Management Professional with over 9 years of healthcare and pharmaceutical experience supporting patients with rare diseases. Proven success in navigating complex reimbursement processes, facilitating prior authorizations and appeals, collaborating with payers and specialty pharmacies, and educating providers and patients to ensure timely access to therapy. Recognized for compassion, problem-solving, and cross-functional collaboration that improves patient outcomes and reduces barriers to care.

Core Skills & Expertise

• Patient Eligibility & Benefits Investigation • Alternate Funding Resources

• Prior Authorizations & Appeals • Product Launch & Patient Onboarding

• Case Management & Patient Advocacy • Provider & Patient Education

• HUB & Patient Support Services • Cross Functional Collaboration

• Specialty & Retail Pharmacy Coordination • Salesforce CRM

• Reimbursement & Payer Relations • Microsoft Suite Career Experience

Patient Access Manager, Occam Health Services-Headquarters in Sterling, VA-Remote November 2024-June 2025

• Increased program adoption and improved patient access outcomes by educating healthcare providers and staff on access and affordability programs for designated therapies.

• Accelerated therapy initiation by successfully managing the end-to-end reimbursement journey including patient enrollment, prior authorizations, appeals, and coordination with specialty pharmacies.

• Reduced therapy delays by streamlining access workflows and proactively resolving coverage and authorization challenges, improving overall patient experience.

• Enhanced cross-functional collaboration by working closely with sales, field reimbursement, patient services, and payer teams to support patient access initiatives.

• Shortened patient onboarding timelines by coordinating enrollment, coverage determination, and appeals, leading to faster medication starts and improved patient satisfaction.

• Improved provider efficiency and patient access workflows by educating on digital platforms such as CoverMyMeds, expediting benefits verification and prior authorization processing.

• Served as a subject matter expert on payer and pharmacy processes across the assigned territory, delivering timely market access insights and payer policy updates to internal and external stakeholders.

• Supported a 20% increase in patient pull-through by resolving complex access barriers in collaboration with patient services, market access, and sales teams.

• Ensured accurate and timely responses to coverage and prior authorization inquiries by maintaining up-to-date knowledge of national and regional payer policies.

• Improved patient adherence and reduced delivery delays by optimizing hub services and specialty pharmacy workflows.

• Influenced strategy refinement across cross-functional teams by identifying and delivering actionable insights through data analysis and critical thinking.

• Aligned patient services with corporate values, compliance standards, and quality benchmarks by partnering with Ardelyx sales leadership and field teams.

Kerry Merisier 2

Care Coordinator, Amylyx Pharmaceuticals – Headquarters in Cambridge, MA – Remote March 2023 – June 2024

• Enhanced patient and caregiver experience by delivering compassionate, holistic support to the ALS community through proactive outreach and personalized education on insurance benefits, product use, and disease management.

• Achieved over 95% patient satisfaction by exceeding KPIs and ensuring one-call resolution for patients and healthcare providers.

• Led care coordination for 200+ patients, driving improved adherence and access outcomes through individualized guidance and proactive touchpoints across the patient therapy journey.

• Improved time-to-fill and therapy conversion rates by conducting comprehensive case reviews with HCPs and resolving access barriers related to coverage, documentation, and pharmacy coordination.

• Accelerated prescription fulfillment by streamlining Specialty Pharmacy triage procedures and optimizing CRM documentation workflows.

• Improved access and affordability by collaborating compliantly with field reimbursement and sales teams, sharing insights, and resolving patient-level coverage challenges.

• Maintained 100% compliance in identifying and enrolling eligible patients into co-pay and financial assistance programs, enabling timely therapy initiation and continued adherence.

• Strengthened patient and provider trust by applying critical thinking and active listening to efficiently resolve complex and sensitive cases.

Patient Support Manager, Takeda Pharmaceuticals – Headquarters in Lexington, MA – Remote February 2021 – April 2023

• Promoted therapy adherence and improved treatment outcomes by educating patients and caregivers on approved therapies for primary immune deficiencies.

• Maintained uninterrupted therapy access by partnering closely with healthcare providers to navigate insurance verification, prior authorizations, and complex coverage challenges.

• Reduced denial rates by proactively validating insurance coverage and resolving documentation gaps before claims submission.

• Lowered out-of-pocket costs and removed financial barriers to therapy initiation by securing appropriate financial assistance for eligible patients.

• Accelerated therapy initiation and improved medication access by coordinating with Specialty Pharmacies and internal departments to ensure timely delivery.

Executive Concierge, Bozzuto Properties, Cambridge, MA February 2019 – January 2021

• Improved service delivery and team performance by guiding and mentoring concierge staff through comprehensive training and ongoing support.

• Reduced staffing gaps and administrative errors by strategically managing shift schedules and payroll processes, ensuring consistent and efficient front desk coverage.

• Contributed to high resident satisfaction and retention by resolving concerns promptly and professionally, reinforcing a positive and responsive service experience.

Clinical Associate, Winchester Hospital, Winchester, MA June 2013 – May 2018

• Enhanced patient comfort, safety, and recovery results by delivering compassionate, high-quality care to post-operative patients.

• Improved clinical efficiency and patient responsiveness by assisting nursing staff with the execution of individualized care plans and daily workflows.

• Ensured accuracy and regulatory compliance by maintaining detailed and timely patient documentation in accordance with hospital policies and procedures.

• Boosted onboarding effectiveness and team cohesion by training and mentoring new clinical associates, contributing to a more confident and capable care team.

Education

Associate Degree in Liberal Studies Middlesex Community College, Bedford, MA

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