Resume

Sign in

Insurance Analyst/ Benefit verification Specialist Pharmacy Setting

Location:
Waukegan, Illinois, United States
Salary:
$25.00- $30.00
Posted:
October 12, 2016

Contact this candidate

Joan Masotas-Hoel

*** * ***** ***

Waukegan, Illinois 60085

Home Phone (847) ***-****

Cell Number (847) ***-****

acw0tn@r.postjobfree.com

PROFESSIONAL OBJECTIVE:

To obtain a secure position where my skills and training can contribute to the” Bottom Line” in quality patient care and customer service.

QUALIFICATIONS:

• Proficient and Professional

• Highly experienced in customer service, patient care and staff support

• Acclimated to various correspondence

• Strongly committed to co-operative teamwork

• High trained in medical terminology

• Background training in pharmaceuticals

• Excellent skills in Communication and facilitation

• Highly organized and able to multi task

• Acclimated in all aspects of Insurance handling

RELEVANT EXPERIENCE:

11/2011-Present Pharmacy solutions/ Abbott Laboratories Abbott Park IL

Insurance Analyst II/Certified Pharmacy Tech CPhT

Heavy communication with providers and payers to obtain patients medical and pharmacy benefits. Determine patient’s financial responsibility as well as obtain pre-authorization and pre-determination requirements.

Communication to both patient and physicians on status of referrals and prior-authorizations.

Assist physicians’ offices through entire process of obtaining prior-authorizations and pre-determinations as well as appeals.

Identify and populate appropriate BV forms, letters and fax templates, in order to communicate efficiently with patients and physicians.

Identify potential financial assistance for patients who are either un-insured or under-insured. Such as PAP, LIS, Copay Cards and Independent Copay foundations.

Refer patients to Abbott’s Humira protection plan, myHumira and other support programs available.

Utilize on line web tools to establish eligibility and insurance benefits.

Humira certified.

Collect data, establish facts, draw conclusions and solve problems.

Team player with in territory pod as well as all other departments within the pharmacy.

Submissions/Insurance exceptions Tech

04/2010-09/2010- U.S Census Bureau Washington D.C

Enumerator

• Received assignments

• Located housing units and conducted interviews.

• Explained the purpose of the census and recorded data on paper questionnaires.

• Conducted quality control checks and re-interviews.

• Handled difficult and irate residents.

09/2008-03/2009- Caremark/CVS Lincolnshire IL

Benefits Verification Specialist/ Pharmacy Division

• Verified patients insurance benefits for specialty drugs.

• Scheduled shipping of medication from pharmacy to patients home or Dr’s office.

• Worked with traditional insurance as well as Medicaid and Medicare.

• Resolved billing and shipping issues with other staff members.

• Worked with various medications including Humira, Lupron, Synagis and others.

Other Relevant Experience:

• Best Buy-customer service- 07/2005-12/2007

• Lake Forest Hospital- Unit Secretary/ Scheduler- 01/02-05/03

• Bonnie Brook Fire Department- Firefighter II EMT-B-07/02-05/03

EDUCATION:

College of Lake County:

Pre-nursing, Fire service, Emergency Medical Tech

Carmel High School for Girls:

Diploma

Penn Foster:

Pharmacy Technician/Licensed Pharmacy tech



Contact this candidate