Patient Access & Reimbursement Manager
Resume:
Amy Neisler - RHIA, PACS
Lyons, Kansas 67554
***********@*****.***
OBJECTIVE
I am a seasoned Field Reimbursement Manager with a demonstrated history of field based roles focused on educating healthcare professionals on the reimbursement landscape. I thrive to develop strong relationships to reduce reimbursement and coverage barriers. My success stems from a consultative approach, as the epicenter I am skilled at navigating the complexities of Specialty Pharmacy, and Buy & Bill products/services. I ensure pull-through for patient access to therapy via Assistance Programs.I have been an integral part of the launch of drugs/devices in Hematology, Rheumatology, andGastroenterology. I intend to share my passion with my team for connecting patients with life saving treatments that will enrich their lives.
EMPLOYMENT HISTORY
McKesson/CMM 01/22-current
FRM Midwest Region-
Cardiology BMS CAMZYOS
● Manage assigned territory focused on supporting reimbursement and patient services
● Provide on-site and on-demand education for the office staff on reimbursement challenges and support services
● Monthly trending activity data of Medicare and commercial coverage
● Reimbursement support on case management, billing & coding updates, appropriate claims submission & appeals
● Responsible for collaborating with HUB and Escalations as necessary
● Daily tracking of interactions/activities in FRM CRM and submission
● Weekly collaboration with team to ensure unity of reimbursement resources and messaging
CareMetx 8/21-12/21
Access Specialist/ Novartis LEQVIO
● Provided guidance to physician office staff and patients on how to complete and submit all necessary program applications in a timely manner
● Performed reimbursement activities related to PAs, claims, & appeals
● Provided excellent customer service to internal and external customers; resolved requests in a timely and accurate manner; escalade accordingly
● Analyzed data/ problem solving
Medical Practice Manager 5/19-9/20
Health Now Family Practice
● Maintained Provider Credentialing & Insurance Contracts
● Developed organizational procedures and systems for office: payroll & scheduling
● Ordering supplies and equipment
● Revenue Cycle Management: all coding, billing, claims
● Established team atmosphere through leadership and employee development
Independent Consultant 10/17-3/19
● Field Reimbursement ( J&J), Revenue Cycle Management, Physician Coding & Billing, A/R & Collections
UBC/ Express Scripts/ Amgen 7/16-9/17
Field Reimbursement Manager/Patient Access- Western Region
Nephrology Drugs: Sensipar and Parsbabiv (sHPT)
● Served as local market coverage and access expert to minimize reimbursement barriers for patients and providers and optimed access to products in assigned territory
● Supported associates/ directors with direct day to day reimbursement activities and client communication
● Assisted with ongoing client account management for reimbursement related projects
● Provided client specific training on reimbursement and access services via PowerPoint presentation, thus cultivated strong relationships
● Identified needs/ gaps in product access and assisted in overcoming barriers and gained access for patients to medication/ therapy
● High level customer service helping with overall claims management, billing, proper authorizations, and denial/ appeals
**Health Sabbatical 3/14-6/16
Xcenda/ Amerisource Bergen/ Pfizer 10/13-2/14
Field Reimbursement Specialist - Midwest Region
Rheumatology - Xeljanz (RA)
● Interacted and developed relationships with entire office staff and provided education to ensure patient access to medication
● Increased operational efficiencies for successful integration and utilization of patient financial assistance programs within accounts, (Trial Rx, Interim Care Prescriptions, Co-pay Savings Programs, Hardship Assistance, PAP)
● Reduced practice level reimbursement issues via review of revenue cycle and claims management processes by 15%
● Communicates with all stakeholders of team and provides feedback to improve processes
Endogastric Solutions 6/09-1/13
Senior Reimbursement Specialist- Western Region
Gastroenterology- EspophyX Medical Device
● Developed marketing/sales documents for use by sales team: site specific medicare reimbursement slick, coding & billing guide, MAC Grid/Coverage Policies and Payer Mix
● Conducted payer policy reviews and implemented action plans that resulted in positive coverage for millions of covered lives
● Managed HUB staff daily/ continued education and support
● Provided direct B-B reimbursement support for all customers; Physicians and hospitals: C level Suite Meetings, Provider Presentations/Luncheons
● Increased sales with developed relationships and ongoing support to all clients and HUB
● Researched, monitored, and maintained payer policy database for top 25 commercial payers, Medicare, and Medicaid- used Target Strategy
Reimbursement Principles 5/08-6/09
Reimbursement Manager
● Reimbursement Assessments
● Payer Educational Campaigns
● CPT/ J Code/ or other new code application support
● Customer Service/Sales Preauthorization & Hotline Support
● Commercial, Medicare & Medicaid coverage policy research
Western Skies Billing 8/06-2/08 Billing Training Coordinator
● Developed training manual and course for all employees
● Conducted audits to ensure no lost revenue
● Patient Collections/Bad Debts
● Reduced overall A/R 20%
● Report generation to located payor payment trending
● Payer Contract review/update
PMIS 12/00-6/05
Account Manager
● Managed A/R for multiple clients
● Patient Collections activities
● Charge posting
● Insurance and patient payment posting
● Customer Service
Rose Medical Center/ HealthOne 1/99-6/99
Data Quality Analyst
● Managed Inpatient and Outpatient Coding
● Performed DRG audits to ensure optimization
● Conducted concurrent training and education of staff
Exempla Saint Joseph Hospital 6/98-11/98 Clerical Supervisor
● Ensured complete and accurate medical records
● Physicians transcription/ signature of reports
● Assembly and analysis of inpatient records
● Met JCAHO requirements/ certification
● Responsible for overall management of 12 FTEs
● Reduced yearly departmental budget by 10%
Carbot Marsh Corporation 1/96-05/98
Health Information Consultant
● Data Quality Reviews
● DRG Optimization
● Charge Master Analysis
● Training and Educational Symposiums
● Backlog Coding, (Inpatient, Outpatient, ER)
St. Francis Hospital 4/95-01/96
Data Quality Analyst
● Overall supervision of 50 FTEs
● Training/ Education/ QA Inpatient & Outpatient Coding
● JCAHO standards met for incomplete records
● Decreased annual department budget by 10%
● Increased Medicare reimbursement by 20% with implementation of concurrent coding
● Productivity increase in all parts of the department/ overall increase 22%
Avista Adventist Hospital 6/94-02/95
Coding Supervisor
● Inpatient/ Outpatient Coding
● Managed A/R report
● Verified Colorado Hospital Association Discharge Data
Platte Valley Medical Center/ SCL Health 7/93-06/94
Outpatient Coder/Abstractor
● Outpatient Coding and Abstracting
● Worked denied claims and appeals
● Assembly/ Analysis of OP charts
EDUCATION
● The University of Kansas
BS/ Healthcare Administration/ RHIA 1993
● Butler County Community College, 1991
Associate of Science, Business
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