Casilia Henry
**** ****** ***** **** *** *** Charlotte NC 28216
adb7xe@r.postjobfree.com
Qualifications Summary
Interim Team Coordinator, Trainer, Reimbursement Counselor, Quality Assurance, Assistant Manager, Medical Assistant, Insurance Verification Specialist, Audits and Appeals as well as Customer Service experienced working in fast-paced environments demanding strong organizational, technical, and interpersonal skills. Trustworthy, ethical, and discreet, committed to superior patient care. Confident and poised in interactions with individuals at all levels. Well-versed in health insurance and medical office procedures. Capabilities include:
Supervisor Experience: Lead Supervisor, Assistant Manager
Computer Operations: Microsoft Excel, Microsoft Word, Medical Office Software
Medical Education: Completion of Medical Assistant courses at MedVance Institute with honors
Medical Courses: Anatomy & Physiology, Clinical Lab, Phlebotomy, EKG, Law & Ethics
Office Equipment Operation: PC Navigation, Fax, Copier,
Certifications: CPR, and Leadership, First Aid, HIV
Telephone Reception: Scheduling, Appointment Setting
Leadership Courses: Building Relationships with Customers, Employees, and Clients
Recruitment: Interviewing and screening for job placement
Experience Highlights
Interim Team Coordinator /Patient Access Specialist, AmerisourceBergen Co. Charlotte, NC 10/2017-Current
Trained associates members on program standard operating procedures for AR Regeneron Eylea
Compiled a wide range of routine reports related to program operations for program management and clients
Monitors adherence to standard operating procedures.
Audits program activity related to contract and data integrity
Understands program contract obligations and is able to communicate in order to drive program performance
Participated in team meetings, prepared agenda, and meeting notes.
Provides day-to-day mentoring to team members on performance metrics, program processes ensuring team members are performing in-line with program standards.
Pre-screening candidates by using preliminary assessment through interviews and job simulations to select candidates with the highest potential for job success.
Patient Access Specialist, AmerisourceBergen Co. Charlotte, NC 09/2014-10/2017
Trained on the techniques of performing a thorough benefit verification
Using our Patient Plus patient management suite to ensure comprehensive benefit verification
Probe to uncover reasons for non-coverage, provide payer education around product benefits and track/deliver data to manufacturers around payer policies
Facilitate the prior authorization process on behalf of patients to the degree allowed by the payer, supporting patients through any required administrative paperwork with the goal of removing all hurdles to product access
Assisted with verification of benefits for Medicaid, Medicare, and Private Commercial policies
Addressing inbound inquiries regarding the billing, coding and claims submission process
Assisted Reimbursement Counselors with Sit-Ins for program procedures
Responsible for updating patient and provider information
Research requirements for patients whose claims have been denied and ensure payer forms are complete
Seamlessly support the specialty pharmacy triage process with extensive experience across multiple programs, we review incoming requests and triage to the appropriate specialty pharmacy based on manufacturer-desired business rules
Customer Service Professional, Connextions Inc., Concord, NC 05/2013-09/2014
Customer Service Representative responsible for assisting members enrolled in a Medicare Prescription Drug Plan through United Health Care
Processing prescription request through OptumRx clinical pharmacies
Premium billing payment assistance and inquiry solutions
Insurance eligibility and verification confirmation processing
Fulfillment request materials distribution
Customer Service Representative, Convey Health Solutions, Ft. Pierce, FL 12/2012-4/2013
Customer Service Representative responsible for assisting members enrolled in Silverscript with account
Information
Processing prescription request through CVS clinical pharmacies and its affiliates
Premium billing payment assistance and inquiry solutions
Insurance eligibility and verification
Quality Assurance Assistant Manager, Ivox Solutions, Palm City, FL 05/2010-12/2012
Customer service representative rapidly promoted to a Lead Supervisor
As an Assistant Manager, oversaw twelve employees supervising system log in time, monitoring, and assisting with questions and concerns
Responsible for submitting daily reports, agent summary reports, and enforcing company rules and regulations as well as adherence to policies and procedures
Medical Receptionist, Coastal Primary Care, Ft. Pierce, FL 2/2008-9/2008
Set appointments for new and established patients of a family practice office
Faxing and filing medical documents
Responsible for retrieving authorizations and referrals
Accurately and efficiently verified insurance coverage
Administrative Assistant, Humana Marketpoint, Stuart FL 5/2007-8/2007
Performed administrative and secretarial support functions for Humana
Coordinated and managed multiple priorities and projects. Provided discreet secretarial and reception services for an insurance company
Maintained accurate and up-to-date confidential client files
Provided telephone support, investigated and resolved billing problems for clients enrolled in the insurance company
Document Acquisition, Liberty Medical Supply 1/2006-1/2007
Registered incoming patients for diabetic supplies for Liberty Medical Center. Order intake as well as prescription preparation
Retrieving and distributing doctor orders for diabetic patients. Distributing claim checks to individual approved by the state
Demonstrated the ability to work efficiently in a fast-paced environment while preserving strict confidentiality
Responsible for the verification of insurance, appointment setting, referrals, and authorizations
Education & Training
JSG Medical Group Dr. Gorodetsky, Stuart, FL (5/2012- 6/2012) Medical Assistant Externship
MedVance Institute, Port St. Lucie, FL (2011-2012) Medical Assistant Diploma
Indian River State College, Ft. Pierce, FL (2006-2009) Concentration in Nursing
PCDI, Technical College, Orange, NJ (2001-2003) Certification in Medical Billing
Professional References
Abigail Thompson Human Resources Manager 772-***-****
Ruth Ann Duren Career Services Director MedVance Inst. 772-***-****
Community Involvement
Enrolled in the Hurricane Katrina Disaster relief counsel and received plaque award for services delivered for the 2005 Hurricane Food for Florida Program. Extensive involvement of people affected in communities from Hurricane Katrina.