Customer Service Pharmacy Claims

Yvonne Grier

Charlotte, NC

Results-driven healthcare and administrative professional with experience in pharmacy claims processing, patient benefits coordination, and medical documentation. Demonstrated ability to manage and streamline operations in remote and in-office settings, ensuring compliance and high-quality outcomes. Proven track record of achieving performance targets, providing exceptional customer service, and effectively liaising between patients, healthcare providers, and insurance companies. Proficient in medical transcription, insurance verifications, referrals and authorizations, and utilizing electronic medical records (EMR) systems.

RELEVANT PHARMACY/HEALTHCARE EXPERIENCE:

REMOTE Pharmacy/Patient Benefits Specialist (Contract)

Cencora / Greenlight Connections 10/2023- 12/2023

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

REMOTE Pharmacy Claims Billing Specialist (Contract)

IBM - Express Scripts/ Cigna 09/2021 - 12/2022

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.

REMOTE Documentation Extractor

HIM Documentation Reviewer Service 01/2015 - 01/2017

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.

OTHER PROFESSIONAL EXPERIENCE:

CEO, Exclusive Notary Public Services 08/2022-Present

Witness the signing of official documents and verify the identity of the signees. Administer oaths and affirmations, maintain notary journals, and manage various legal documents such as contracts, affidavits, and loan documents for the State of North Carolina.

Administrative Office Assistant/Medical Secretary

Matthews Radiation Oncology, Matthews, NC 08/2006 -10/2020

Manage and participate and perform duties to include appointment setting, insurance verifications, and medical documentation for perspective patients. Review of financial information of patient to ensure no treatment delays. Customer service, problem solving. Liaison between physicians, therapists, referring medical providers. Prior authorizations, and referrals 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 regular position, edited and processed 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.

CEO, Transcriptionist

Transcription Variations Unlimited, Charlotte, NC 01/2000 – 01/2021

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

EDUCATION:

Associate degree in Business Communication & Concepts

Queens College- Charlotte, NC- 2000

Central Piedmont Community College -Matthews Campus

Notary Public 1, 2022-2023

Notary Public/ Civil Services

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

Contact this candidate