Senior Reimbursement Specialist (Bilingual- French & English)

Oshawa, ON, Canada

Full Time

Experienced

#LI-DNI

JOB DESCRIPTION

POSITION Senior Reimbursement Specialist (Bilingual- French and English)
COMPANY AND LOCATION Auxilium Health (Hybrid), Oshawa ON
EMPLOYMENT TYPE Full-time, Permanent
HOURS WORKED 37.5 hours per week, Monday-Friday, 9 am – 5 pm or 12 pm – 8 pm

DEPARTMENT Patient Support Programs
REPORTING TO Manager, Patient Support Programs
DIRECT REPORTS No
LAST UPDATED January 2026

POSITION SUMMARY:
The Senior Reimbursement Specialist is responsible for overseeing all aspects of patient enrolment into our Patient Support Programs and providing advanced reimbursement navigation for patients prescribed therapy by their physician. This role requires in-depth knowledge of the Canadian national reimbursement landscape, including all provincial public plans and private insurance plans, and supports complex access scenarios such as medications requiring Exceptional Access Programs (EAPs) via SADIE (the Special Authorization Digital Information Exchange).
The Senior Reimbursement Specialist serves as a subject-matter expert, supporting patients, physicians, and internal stakeholders by ensuring timely, compliant, and seamless access to prescribed therapies through proactive reimbursement support, education, and coordination of services.
GENERAL RESPONSIBILITIES & ESSENTIAL FUNCTIONS:

Lead and manage complex patient cases, removing barriers to access for prescribed medications
Receive escalated cases, review and refine documentation as needed, collaborate with Case Managers on updates, and submit cases to the appropriate internal or external stakeholders
Provide advanced education and guidance to patients, HCPs (Health Care Providers), and clinic staff regarding Program services and reimbursement pathways
Respond to inquiries from patients, HCPs, and clinic staff in a timely, professional, and accurate manner, including complex scenarios
Support and expedite access to medication by providing reimbursement navigation and assistance with patient out-of-pocket costs
Act as a key liaison between patients, HCPs, clinic staff, and Key Account Managers to support medication acquisition, access, coverage, reimbursement, and affordability
Conduct comprehensive reimbursement investigations across private and public insurance plans
Review, analyze, and validate complex patient and payer information to ensure accuracy, completeness, and timely initiation of Program services

Support medications requiring Exceptional Access Programs (EAPs), including preparation, submission, tracking, appeals and follow-up of EAP requests

Utilize the SADIE portal to submit, manage, and track EAP applications in accordance with provincial requirements
Generate, review, and provide applicable reports to support Pharmacovigilance monitoring and compliance, ensuring timely and accurate data capture in alignment with regulatory and program requirements.
Serve as a subject-matter expert on reimbursement processes, ensuring they remain current and providing guidance and informal mentorship to team members as required
Collaborate with management to support quality and process improvement initiatives
Deliver spoken and written French-language translations to support Program and team needs as required
Ensure all activities are conducted in alignment with Program guidelines, payer requirements, and compliance standards
Perform ad-hoc duties as assigned by the Management team

QUALIFICATIONS

A minimum of three years of experience working in patient support programs
Demonstrated experience providing reimbursement and access support across a diverse range of therapeutic areas, including but not limited to neurology, oncology, ophthalmology, and autoimmune/immunology
Proficiency in French and English required
Strong written and verbal communication skills
Demonstrated professionalism, compassion, and patient-centric approach
Ability to manage multiple complex cases and competing priorities with urgency in a fast-paced environment
Demonstrated ability to quickly adapt to new and evolving technologies
Experience with Salesforce, DocuSign, Adobe, and Microsoft Office applications is a strong asset
Advanced knowledge of the Canadian reimbursement landscape, including public and private insurers
Demonstrated experience supporting medications requiring Exceptional Access Programs (EAPs), including hands-on use of the SADIE portal
Strong problem-solving, analytical, and critical-thinking skills
Experience in the healthcare, pharmaceutical, or insurance industry required

EDUCATION

Completion of post-secondary school required

WORKING CONDITIONS:

Candidates must be available for variable weekly shifts, scheduled either daytime (9:00 AM – 5:00 PM) or afternoon/evening (12:00 PM – 8:00 PM) hours, Monday to Friday
Remote, home-office environment or office environment: sitting at a desk, working at a computer

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Do you have at least three (3) years of experience working in a Canadian Patient Support Program (PSP)?*

Do you have hands-on experience navigating Canadian public and private reimbursement plans, including provincial public formularies?*

Have you independently prepared, submitted, and managed Exceptional Access Program (EAP) requests, including hands-on use of the SADIE portal?*

Are you professionally fluent in both written and spoken French and English, with experience using both in a healthcare or patient-facing role?*

Have you led complex or escalated reimbursement cases independently, including denials and appeals?*

Are you legally able to work here in Canada?*

Are you able to flexibly work a variable weekly schedule of shifts either 9:00 AM – 5:00 PM or 12:00 PM – 8:00 PM?*

Do you have reliable means of transportation to fulfill the in-office requirements of this role?*

What is your desired annual salary range?*

Are you fluent in French?*

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Senior Reimbursement Specialist (Bilingual- French & English)

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