Manager Medical Assistant

Christi Dyer

Email: abo5q1@r.postjobfree.com

Address: **** ***** *** #****

City: Sacramento

State: CA

Zip: 95833

Country: USA

Phone: 972-***-****

Skill Level: Experienced

Salary Range: 50

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

Christi Dyer

2942 Weald Way #2424

Sacramento, CA 95833

Cell Ph# 469-***-****

EXPERIENCE

2010-2012 CVS/Caremark Irving, TX

Medicare Part D Consultant

. Review benefit change forms for accuracy. Ensure client documentation and system set-up aligns with the changes requested. Research system set up inquiries and identify trends. Code benefit changes into the system as needed. Interface with internal and external clients via conference calls and written communication. Accountable for ensuring accurate benefit design set up through system testing and validation. Following up with internal and external parties as needed. Mentoring Internal and external partner regarding system functionality and or limitations. Perform root cause analysis.

2006-2010 CVS/Caremark Irving, TX

Benefits Analysts

. Work with internal BRM, Clinical dept and Account manager as well as external partner to ensure benefit plan designs are accurately coded and tested within the client contracted turnaround time to prevent any service warranties or performance guarantee violations.

. Build testing environment in AS400/RX Claim with complete testing to ensure satisfactory results per client intent using RX test suits/Manuel testing in live or test environment.

. Run complete Query drug data report daily to ensure Medispan update are up to date per plan NDC/GPI list and to ensure plan designs are precise per client intent.

. Build Matrix specific to plan design.

. Macro testing to improve plan code efficiency.

. Implement New Plan design.

. Research member claims and plan design questions.

2000-2006 Caremark Specialty Dept Richardson, TX

Resolution Representative II

. Research and articulately communicate information regarding member eligibility, plan benefits, and claim status while maintaining confidentiality.

. Assist Pharmacies w/claim info (i.e., Bin#, group#, plan code id#) to insure member claims pay correctly (pharmacy help desk).

. Provide info regarding In and Out of network reimbursement rates

. Provide direct member reimbursement and assist w/coordination of benefits.

. Process and maintain override request for claims that meet plan criteria.

. Research and analyze claim issues.

1999-2000 Kaiser Permanente Sacramento, CA

Medical Assistant

. CPT coding, for billing purposes

. Checking and recording vitals

. Filing and maintaining pt charts

. Assist Dr in procedural exams and surgeries

COMPUTER

. Microsoft Outlook, Word, Excel and Access.

. Proprietary Pharmacy System: Bart II, PeopleSoft, CPR+, STARS, AMOS, RXClaim (AS400), Recap, Daytech, Seible, RTD manager.

EDUCATION

. National Career Education (Certified Medical Asst) Sacramento, CA

. American River College (Business Admin) Sacramento, CA

. Medicare Part D proficient (Medicare compliant) CVS/Caremark Irving, TX

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