My Experience

Work Experience

Job Title

Pharmacy/Patient Benefits Specialist

Company

Cencora Global Services

Location Remote

**/****- **/****

Role Description:

Process pharmacy claims, setup shipments, process credit card/cash payments for medications, reconcile. Authorize applications/ patient and physician offices. Referrals, authorizations, utilization management. Follow through until patient delivery is completed. Act as a liaison for patient, facility, physician offices, pharmacy. Daily achieved results equals 93%.

Job Title

Pharmacy Claims Billing Specialist

Company

Express Scripts/ IBM/ Cigna

Location

Remote

From

9/2021

To

12/2022

Role Description

Process pharmacy claims, follow up insurance information of patient, phone calls to patient and manufacturers for accurate information for successful claims processing. Bill and process credit card payments for medications. Benefits verification, patient liaison, navigator, provide insurance benefits/verification, payment options, referrals, authorizations to the patients, etc. Daily results achieved 94% with an anticipated quota of 25-30 clean claims.

Work Experience

Job Title

Administrate Office Assistant/Medical Secretary

Company

Matthews Radiation Oncology

Location

Matthews, NC

From

08/2006

To

10/2020

Role Description

Manage and participate and perform duties to include appointment setting, insurance verification, and medical documentation for perspective patients. Customer service, problem solving. Liaison between physicians, therapists, referring medical providers. Prior authorizations for specialty treatment for cancer, i.e. providing diagnosis codes, metrics, for treatment, dosimetry specs, and follow up for future treatments, schedule or refer for procedures/surgery to outside hospital facilities/surgery centers. While following up on referrals. Output of quality achieved daily well exceeded 95-100%. Retrieving radiology/medical information and creating CDs for radiation therapy. (During Transcription for facility i.e. editing and mailing out correspondence to referral sources- Contractor.) 100% daily with a patient load of 65 70 scheduled per day..

Work Experience 3

Job Title

Documentation Extractor

Company

HIM Documentation Reviewer Service

Location

Remote

From

1/2015

To

1/2017

Role Description

Extract medical information, i.e. lab reports, Radiology reports, medications, treatment plans for proper chart processing for EMR. Provided information for physicians, pharmacy, insurance companies. Total achieved results 25 charts per event.

Work Experience 4

Work Experience 4

Job Title

Transcriptionist

Company

Transcription Variations Unlimited

Location

Charlotte, NC

From

1/1997

To

1/2015

Role Description

Managed and Owner of Remote Transcription Service for medical facilities/hospitals, global organizations, US Military/ commercials, plays. First to introduces digital transcription to physicians for outside transcription services. Managed 5 part-time employes with a daily chart completion rate of 45.

Education

School or University

Central Piedmont Community College Business Concepts

Degree

Associates

Field of Study

Business Education

Overall Result (GPA)

90

Education 2

Central Piedmont Community College- Matthews Campus

Degree

Civil Law

Field of Study

Commerce/ Loan and title closings.

Overall Result (GPA)

A

From

2021

To (Actual or Expected)

2021 and 2022

Skills

Payments

Reimbursement

Credit

Billing

Healthcare Contracts

Claims Processing

Insurance Authorizations

Insurance Utilization

Data Extraction

Transcription

Research

Healthcare experience- 20+

Managerial xs 15 years.

Certification: NOTARY PUBLIC- State of North Carolina - #202*********

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