EMPLOYMENT HISTORY

Covance San Diego, CA Nov. ***9 - Present

Program Associate (May 2013 – Present)

-Conduct insurance verifications, facilitate the prior authorization process on behalf of customers, and perform reimbursement case management to identify insurance and alternative funding sources. Handle complex reimbursement cases and relay results to customers.

-Provide claim support services by identifying reason for denial and low payment and recommends appropriate strategy for the client program

-Support payer advocacy efforts as appropriate to overturn negative payer policies.

-Identify program trends and opportunities for intervention with payers and provide recommendations to the Operations Supervisor, Program Manager or Account Director.

-Conduct teleconference and or webex presentations on program specific material.

-Review difficult or special exception cases and provide recommendations to the Operations Supervisor, Program Manager or Account Director.

-Conduct outbound calls to increase patient compliance with treatment protocols, if appropriate.

-Manage difficult customers. Serve as escalation point for complex reimbursement calls, difficult callers, and customer complaints. Address and resolve customer issues involving customers in decision making process to ensure that their needs are being considered.

-Serve as subject matter expert and lend technical expertise. Respond to inquiries from clients, patients, or operations staff regarding third party payment, patient assistance, or other issues related to client specific programs.

-Develop reports and retrieve data as necessary. Responsible for generating standard reports.

-Actively participate in ITC and client processes to ensure work is completed in a timely and efficient manner. Ensure high quality work is delivered and performance measures are met. Conduct peer data audits as necessary. Provide informal mentoring to Program Specialists, Program Representatives and Program Assistants when appropriate

-Conduct training for new services and products as needed for veteran staff. Conduct training for new employees assigned to specific programs.

-Conduct teleconference and WebEx presentations for customers, who may include physicians and their staff, hospital staff, pharmacists, and members of the clients’ sales force.

-Meet work schedule assigned on a daily basis, per ITC staffing and capacity analysis

Program Specialist (Nov. 2009 – May 2013)

-Conduct insurance verifications, facilitate the prior authorization process on behalf of customers, and perform reimbursement case management to identify insurance and alternative funding sources.

-Assist with training new and transferring employees (including contract agents) to help them learn the program in an efficient manner.

-Screen and process patient assistance applications by determining eligibility and making outbound follow up calls as necessary. Update computer systems on patient enrollment, denials, withdrawals, shipments, and caller requests. Respond to inquiries regarding PAP operations and requests, such as status of patient enrollment, product shipments, and returns. Also work with distributors and manufacturers to request and track product shipment.

-Actively participate in ITC and client processes to ensure work is completed in timely, efficient, high quality manner, and performance measures are met.

-Other duties as assigned.

Construction Notice Services San Diego, CA 2007 - 2009

-Researched information for customer preliminary notices

-Contacted customers for information regarding their projects

-Ran title searches for owner information

-Managed other researchers under me

-Assisted receptionist with clerical duties

THERAPEUTIC EXPERIENCE

-Musculo-skeletal indications (Multiple Sclerosis)

-Palmar Fascia indications (Dupuytren’s Contracture)

LANGUAGE CAPABILITIES

English

EDUCATION

San Diego City College, San Diego, CA

MEMBERSHIPS

N/A

Skills

Microsoft Word

Microsoft Excell

Microsoft Powerpoint

Outlook

Siebel 7.9

Siebel 8.0

Adobe Acrobat

10-key

78 WPM