Senior Reimbursement Specialist
Resume:
TS
OBJECTIVE
To achieve and exceed corporate objectives with a reputable company, offering challenging responsibilities, advancement and provide an opportunity to significantly contribute to the company's organization, efficiency, growth, and profitability.
SKILLS
Self-Motivation
Conflict Resolution
Time Management
Efficiency
TAVIEN SINES
100 C R ROAD REEDSVILLE, WV 26547
(304) 435 – 8983 ***********@*****.***
TT
TAVIET
EXPERIENCE
SENIOR REIMBURSEMENT SPECIALIST • UBC • SEPTEMBER 2019 – CURRENT
Managed numerous clinics, offices and inpatient pharmacies throughout territories in Texas, Oklahoma, Colorado, Nebraska, Washington and Oregon.
Receive inbound and make outbound calls to Health Care
Professionals, patients, payers, and manufacturer sales
representatives.
Provide assistance with reimbursement inquiry requests,
Including insurance benefit verification, prior authorization denials and appeals, and other reimbursement issues.
Conduct general payer research.
Work with payers and healthcare professionals to resolve prior
authorization issues and/or Appeals and denials.
Identify complex cases and triage appropriately to next level.
Maintain knowledge of coverage policies for Medicare, Medicaid,
and private commercial payers.
ORDER ENTRY • MATTHEWS INTERNATIONAL • SEPTEMBER 2018 – MAY 2019
Received Top Gun (highest output, lowest error rating) for my department for four consecutive months.
Utilize a variety of data entry and word processing programs
Handle high-sensitive data on a regular basis.
Search and retrieve organizational data from an electronic database
PHARMACY TECHNICIAN • WEST VIRGINIA UNIVERSITY HOSPITAL • SEPTEMBER 2016 – MARCH 2018
Compounded chemotherapy, IV and oral medications as directed by pharmacists.
Ensured patient privacy by recording HIPPA paperwork and abiding by regulations.
Mentored numerous new hires through the training and familiarization process.
Received, processed, dispensed and delivered an average of 300 prescriptions daily.
Monitored inventory control systems to ensure stock rotation and current expiration dates.
SUBJECT MATTER EXPERT • AEGIS • JULY 2013 – SEPTEMBER 2014
Accepted and processed customer payments in credit cards and checks, checking for validity.
Acknowledged customer issues and resolved their problems s quickly and efficiently
Fulfilled administrative duties, including completing and filing paperwork and directing a multi-line phone.
KEY HOLDER • KITCHEN COLLECTION • OCTOBER 2013 – JUNE 2014
Accepted and processed customer payments in credit cards and checks, checking for validity.
Acknowledged customer issues and resolved their problems s quickly and efficiently
Fulfilled administrative duties, including completing and filing paperwork and directing a multi-line phone.
EDUCATION
BUSINESS ADMINISTRATION • 102 CREDITS EARNED • WEST VIRGINIA UNIVERSITY
3.5 GPA
REFERENCES
1.Kathleen McDaniel – (304) 288 - 7859
2.Tracy Hovatter – 304-***-****
3.Kelly Guthrie – (304) 288 - 7438
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