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Verification Specialist Customer Service

Location:
Fairmont, WV
Posted:
March 25, 2023

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Resume:

Melanie Koch

304-***-****

Education: Bachelor of Science in Health Science

Lock Haven University

Work Experience: ConnectiveRx

Benefit Verification Specialist

Pittsburgh, Pennsylvania, 15106

● Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients to process patient prescription needs successfully and demonstrate excellent customer service to patients, healthcare professionals and insurance carriers

● Collect the appropriate information needed to ensure insurance coverage for patient medication orders and document in computer systems

● Process patient prescription needs successfully, reduce exposure to adverse events, and demonstrate excellent customer service to patients, healthcare professionals and insurance carriers

● Contact insurance carriers to resolve insurance coverage issues

● Effective communication with patients/families, physicians, third party payors, pharmaceutical manufacturer representatives.

● Represents the company in a competent, professional and responsive manner. Interacts with the operations and quality team consistent with team-building and professional culture established by the company.

● Coordinates the care of patient to assure access to pharmacy products and services. Maintains high quality customer service standards in compliance with federal and state regulations and guidelines.

● Works in collaboration with team members and management to respond to the requests. WV Department of Health and Human Resources

Economics Social Worker

16th Street Wheeling WV, 26003

● Take applications interviews client to gain overview of client financial resources and social circumstances pertinent to eligibility for services; performs in-depth interview to establish eligibility for specific programs and benefits, such as the West Virginia Supplemental Nutrition Assistance Program (SNAP) and medical services.

● Determining eligibility for and managing a caseload for a variety of economic assistance programs.

● Responsible for conducting personal interviews with clients, evaluating, and verifying personal, financial and social information, determining eligibility for services, maintaining a client caseload and referring clients to other social service and community service agencies when appropriate.

● Takes calls from clients and public and sees "walk-ins" requesting information on economic service.

● May obtain repayment from clients who have been issued economic assistance erroneously.

References Available Upon Requests



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