Patient Access Representative III
Resume:
Justice Lopez
** ********* **** #* ******, CO *1001 719-***-****
EXPERIENCE
**/****- ******* ******** ******* Center
Patient Access Representative
Scheduler
Provide over the phone and in person customer service, assisting with scheduling, pre-registration, registering and collections of copays; credit, debit or cash.
10/12/10-2016 Express Scripts
DoD Patient Care Advocate and Pharmacy Help Desk Agent
●Provided Military Beneficiaries with information about their prescriptions, such as their orders, their refills, and/or if they needed new prescriptions.
●Advised patients if they were able to receive their prescriptions or if they needed a Prior Authorization from their Doctor’s Office.
●Sent request to the Doctor’s Office for a new prescription; renewal or a conversion from retail to mail order, all but from Military Treatment Facilities (MTF).
●Advised the member of their balance(s), assisted with making payments and updating their accounts with preferred credit card information or one-time payments over the phone.
●Updated client address for shipping and billing.
●Addressed eligibility issues, transfer to DEERs for proper updates.
●Assisted with navigation through the Tricare Website(s) to the ESI Website.
●Assisted pharmacist with any claims being ran through their pharmacy; from rejections to card information.
Patient Care Advocate
●Provided patients with information about their prescriptions, such as their orders, their refills, and/or if they needed new prescriptions.
●Advised patients if they are able to receive their prescriptions or if they need a Prior Authorization from their Doctor’s Office.
●Sent request to the Doctor’s Office for a new prescription; renewal or a conversion from retail to mail order.
●Advised the member of their balance(s), assisted with making payments and updating their accounts with preferred credit card information or one-time payments over the phone.
●Updated client address for shipping and billing.
2006-2010 Receivable Management Services Pueblo, CO
Senior Representative Application Specialist
●Provided internal Customer Service
●Internally facilitated and taught leadership skills in decision making for customers and application process
●Provided solutions to customer issues/concerns; research solutions when necessary
●Approved “payment arrangements” for customers, within Sprint Guidelines
●Responsible for reading the Command Post which provides for the numbers of available/unavailable representatives
●Monitored hours for representatives, in keeping with schedule
●Provided “Team Leadership”
●Member of the “Care Team,” assisted with reporting (i.e., CERS, SMSI’s, attendance and Daily Utilization)
●Provided individual development plans with representatives with low performance scores; planned for improving performance
2005 – 2006 Premier Fulfillment & Processing Inc. Pueblo, CO
Remittance Clerk
●Processed correspondence as the executive daily operator for several types of client accounts
●Provided internal services (i.e., caging, balancing, depositing of checks, cash money orders, and credit cards)
2000 – 2005 Electronic Network System (ENS) Pueblo, CO
Data Entry
●Provided “electronic data entry” for medical claims
●Provided telephone services and assistance
●Provided re-pricing of medical claims
1999 Pueblo Mall Pueblo, CO
Customer Service/Information
●Answered phones
●Handed cash sales
●Provided gift wrapping services
●Provided information to customers
●Closed Service Desk at the end of the shift
1999 Big R Pueblo Pueblo, CO
Cashier/Sales
●Provided customer service
●Answered phones
●Handled cash receipts
●Stocked and monitored inventory
●Worked with computers for merchandise tracking and orders
●Provided closing for register
1998 – 1999 Big R of La Junta La Junta, CO
Cashier/Sales
●Provided customer service
●Answered phones
●Handled cash receipts
●Stocked and monitored inventory
●Worked with computers for merchandise tracking and orders
●Provided closing for register
EDUCATION
2007 CSU-Pueblo Pueblo, CO
2005 Certified Nursing Assistant Pueblo, CO
1996 University of Southern Colorado-USC Pueblo, CO
●Major Field of Study: Chemistry
●Emphasis: Forensic Science
●Grade Level: Junior Status
1994 – 1995 Otero Junior College La Junta, CO
●Associates of General Studies
●Major Field of Study: Mathematics
1994 Salt Lake Community College Salt Lake City, UT
●Associate of Applied Science
●Major Field of Study: Social Science/Criminology
1992 Highland High School Salt Lake City, UT
●High School Graduate
Customer Service Skills & Experiences
●Organization Skills
●Public Relations Skills
●Computer Registration
●Key Control
●In-House Training
●Typing Skills
●Research
●Microsoft (i.e., Word, Outlook)
REFERENCES
Candace Berumen
2120 Chautard Dr.
Pueblo, CO 81005
Sherri Martinez
646 S. Maher Dr.
Pueblo West, CO 81007
Antointte Solano
****************@*****.***
Ernestine Enriquez
320 E. 10th St
Pueblo CO 81003
719-***-**** home
719-***-**** office
***********@****.***
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