Marissa Chung

Healthcare reimbursement and market access professional with 8+ years of experience navigating complex payer policies, reimbursement requirements, benefits verification, prior authorization, appeals, specialty pharmacy, and patient access for specialty and complex therapies. Experienced collaborating directly with pharmaceutical Field Reimbursement teams and manufacturer programs to resolve complex access barriers. Strong background in rare and complex disease, including NTM, with a demonstrated 95% approval rate for NTM treatment authorizations and selection for an Insmed advisory board.

Hawaii-based with extensive healthcare provider relationships and willingness to travel 60–70% domestically.

Patient Access Manager / Clinic Manager at Oahu Medical Group (2023-11 – 2026-07)

• Served as a payer policy and reimbursement resource for physicians and clinical staff, interpreting commercial, Medicare, and Medicaid coverage requirements and translating payer criteria into actionable guidance for specialty medication access.
• Managed end-to-end reimbursement and access for specialty biologic and infusion therapies, including benefit investigations, prior authorizations, appeals, denial resolution, specialty pharmacy coordination, and manufacturer support programs.
• Conducted detailed benefit investigations to evaluate eligibility, coverage criteria, patient responsibility, prior authorization requirements, referral requirements, and appropriate reimbursement pathways.
• Educated physicians and healthcare staff on payer policies, prior authorization requirements, documentation criteria, reimbursement pathways, specialty pharmacy restrictions, and financial assistance resources.
• Partnered directly with pharmaceutical Field Reimbursement teams and manufacturer support to escalate complex reimbursement cases, identify payer barriers, develop resolution strategies and facilitate treatment initiation.
• Processed 30–50 specialty medication prior authorizations weekly, managing complex benefits verification, payer criteria, clinical documentation, submission requirements, follow-up, and denial resolution across commercial, Medicare, and Medicaid plans.
• Achieved a 95% approval rate for NUZYRA treatment authorizations for patients with NTM, demonstrating strong understanding of payer requirements, clinical documentation, and authorization strategy. Achieved a 98% approval rate for ARIKAYCE authorizations
• Selected to participate in an Insmed advisory board with the marketing team, providing field-based feedback regarding patient resources, support services, and treatment-access barriers.
• Supported implementation of buy-and-bill workflows for long-acting injectable HIV and PrEP therapies, coordinating insurance requirements, provider documentation, pharmacy resources, and reimbursement processes.

Lead Biologics Coordinator at Oahu Medical Group (2018-08 – 2022-04)

• Served as a payer policy and reimbursement resource for physicians and clinical staff, interpreting commercial, Medicare, and Medicaid coverage requirements and translating payer criteria into actionable guidance for specialty medication access.
• Managed end-to-end reimbursement and access for specialty biologic and infusion therapies, including benefit investigations, prior authorizations, appeals, denial resolution, specialty pharmacy coordination, and manufacturer support programs.
• Conducted detailed benefit investigations to evaluate eligibility, coverage criteria, patient responsibility, prior authorization requirements, referral requirements, and appropriate reimbursement pathways.
• Educated physicians and healthcare staff on payer policies, prior authorization requirements, documentation criteria, reimbursement pathways, specialty pharmacy restrictions, and financial assistance resources.
• Partnered directly with pharmaceutical Field Reimbursement teams and manufacturer support to escalate complex reimbursement cases, identify payer barriers, develop resolution strategies and facilitate treatment initiation.
• Processed 30–50 specialty medication prior authorizations weekly, managing complex benefits verification, payer criteria, clinical documentation, submission requirements, follow-up, and denial resolution across commercial, Medicare, and Medicaid plans.
• Achieved a 95% approval rate for NUZYRA treatment authorizations for patients with NTM, demonstrating strong understanding of payer requirements, clinical documentation, and authorization strategy. Achieved a 98% approval rate for ARIKAYCE authorizations
• Selected to participate in an Insmed advisory board with the marketing team, providing field-based feedback regarding patient resources, support services, and treatment-access barriers.
• Supported implementation of buy-and-bill workflows for long-acting injectable HIV and PrEP therapies, coordinating insurance requirements, provider documentation, pharmacy resources, and reimbursement processes.

Referral Response Coordinator at Legacy of Life Hawaii - Organ Procurement Organization (2022-04 – 2023-11)

• Served as a key liaison between physicians, surgeons, hospital administrators, clinical teams, and transplant professionals to coordinate complex, time-sensitive cases and maintain effective communication.
• Managed multiple high-priority cases simultaneously, rapidly assessing clinical information, identifying barriers, determining appropriate next steps, and coordinating resolution in a highly time-sensitive healthcare environment.

Nurse Assistant at Wilson Homecare, (2018-01 – 2018-08)

• Provided compassionate in-home patient care and assistance with activities of daily living, including bathing, grooming, dressing, and mobility support.

BS in Human Development and Family Studies – University of Hawaii At Manoa, 2500 Campus Road, Honolulu, HI 96822