PROFESSIONAL EXPERIENCE

PATIENT ASSISTANCE SUPPORT AGENT, AMGEN (THROUGH ASTON CARTER STAFFING)

TAMPA, FL — AUGUST 2022 - DECEMBER 2023

• Verify HIPPA information and pre-screen to determine if patients qualify to enroll in the Amgen Safety Net Foundation (ASNF). Review documentation on a case-by-case basis to submit to ASNF for final status determination.

• Discuss guidelines and protocols regarding denials and appeals with healthcare professionals

• Review off and on-label ICD-10 codes to report any possible adverse event, product complaint, or other safety findings.

• Experience using Amgen PULSE to initiate the intake process for patients, review and assess eligibility documentation and organize applications

• Refer healthcare professionals and patients to HCP or other medical staff to discuss plan of care and other questions about medical decisions.

• Provide healthcare professionals and patients with contact information for third-party charity patient assistance programs.

INSURANCE VERIFICATION SPECIALIST, THE ONCOLOGY INSTITUTE OF HOPE AND INNOVATION TAMPA, FL — JUNE 2021 - MAY 2022

• Verify insurance, patient eligibility, and coverage.

• Respond to email inquiries regarding status.

• Calculate a patient’s copay according to health plan coverage for chemo drugs and administration. PAYER ENROLLMENT COORDINATOR, CVS HEALTH

WOONSOCKET, RI — OCTOBER 2019 - MARCH 2020

• Process Railroad Medicare applications for providers.

• CAQH experience processing over 3,000 providers in 34 states for MC.

• Assisting with email communications for MC providers. Proficient in MD staff software. INTAKE/ENROLLMENT COORDINATOR, CARECENTRIX

TAMPA, FL — JANUARY 2013 - NOVEMBER 2018

• Contact health plans or payers to gather policy benefits/limitations and complete eligibility and benefits verification to ensure the carrier will cover the services provided.

• Pull forms from different health plans in order to submit clinical docs for review & obtain authorization from the health plan.

• Resolve discrepancies in a professional and timely matter.

• Check patient eligibility and enter it into the system & portal.

• Contact in and out-of-network providers to set up new referrals in order to assign Home Health Services; negotiate rates, and set up Letters of Agreement.

• Participate in voluntary work when Cigna claims need support. Marta Velez

813-***-**** ad4kkp@r.postjobfree.com

CLAIMS ADMINISTRATOR / CHECK LOGGER & CORRESPONDENCE, AETNA TAMPA, FL — JUNE 2010 - OCTOBER 2012

• Use different types of software in order to verify information; ACAS, OPT, ASD, GENELCO.

• Log checks in a timely manner following regulations and procedures.

• Process letters to members & providers requesting overpayment; call providers in order to request more documentation if needed.

• All office duties i.e., filing, faxing, scanning documents, etc. BANKRUPTCY / PROCESSOR / INTAKE SPECIALIST, SHAPIRO AND FISHMAN LAW FIRM TAMPA, FL - JANUARY 2005 TO MAY 2009

• Set up referrals, and enter data into a computer using various data entry devices

• Prepared source data for computer entry by compiling and sorting information

• Reviewed source & pacer & resolve discrepancies.

• Maintained data entry requirements by following techniques and procedures and more

• Reading Pacer Ch. 13 and Ch. 7 Docket

• Informed, and escalated clients of the status of their case by LPS, Vendorscape, Ocwen, Regions, Citi

• Review files from foreclosure and logged out closing files; updated information into the system and notified the client.

• Drafted, reviewed, and sent out bankruptcy correspondence to clients

• All office duties i.e., filing, faxing, scanning documents, etc. EDUCATION

Concorde Career Institute; Tampa, FL - Diploma, Insurance Billing & Coding Specialist, 2010 SKILLS

• Fluent in Spanish and English

• Proficient in Microsoft Office Suite

• Skilled in insurance verification and data entry in a medical setting

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