OPEN for Discussion

Daniel McPherson Jr.

Clermont, FL 347-***-**** adievx@r.postjobfree.com

www.linkedin.com/in/daniel-m-33198a1b/

HIGHLIGHTS

Microsoft Office Suite

PCs, laptops, Windows Operating System

Install/replace hardware and software

Epic Medical EHR Records Management System

Excellent customer service and communications skills

Self-motivated

Learn new concepts quickly

Comfortable in high stress, deadline driven environment

EXPERIENCE

Express Scripts/Cigna, Orlando, FL

Eligibility Senior Representative 10/2019 - Present

Facilitates cross-functional resolution of drug coverage issues & proactively addresses, researches & resolves issues impacting revenue optimization.

Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patient.

Provide expert assistance to clients on patient status.

Coordinate and ensure that all services provided are reimbursable (deductible amounts, co-payments, effective date, levels of care, authorization, etc.).

Assist specialty therapy patients with a variety of government funds and grants.

Enroll patients into co-pay assistant funds online and update in RxHome.

Assist in training new hires.

Brookdale University Hospital & Medical Center, Brooklyn, NY

Admitting Clerk / Representative 01/2005 - 09/2019

Installed printers to Personal Computers in office by network connection.

Troubleshot PCs, photocopy machines and printers.

Interviewed patients and their family to obtain demographic information, nature of visit and to register patients directly into Epic Medical Records System accurately.

Assisted as a super-user in registration areas throughout the hospital, then transitioned from EZ-Access to Epic EHR.

Facilitated Emergency Room and inpatient admissions during Epic system downtime.

Accomplished high bed occupancy by following procedures and policies.

Verified insurance using multiple databases including E-Paces, RTE, & Healthfirst, Navi-Net, Availity, and Affinity online to ensure deemed services were covered.

Prepared death certificates accurately to ensure timely submission on eVital.

Helped train new hires in Admitting Department on the Epic Electronic Health Record (EHR) System.

Obtain signatures required on admission consent forms.

EDUCATION

The Next CISO Apprenticeship Program, Online

GRC, ISO 270**-*****, ISACA, CCSK Expected April 2021

Eastern Gateway Community College, Online

ATS Information Technology Expected June 2023

Contact this candidate