Account Manager, Analyst

Felicia A. Doesburg

***** * ***** ****** ***, Unit 3096, Phoenix, AZ, 85085, US • 602-***-**** • *******.*.********@*****.*** Account Manager/Analyst with 10+ years of pharmacy and PBM experience, excelling in claim validation/quality assurance for standard system coding.

Broad knowledge of pharmacy adjudication systems

4 years experience in standard system coding

Bilingual

Able to work independently

Problem solving

Dependable/Self-managed

Accounting - Some college (No degree)

Berufsbildende Schule für Technologie und Umwelt Wittlich - Wittlich, RP High School

Hauptschule Speicher - Speicher, Germany

Account Manager, Analyst (WFH) - May, 2018 to Present CVS Health - Scottsdale, AZ

Gathered/analyzed complex data identifying trends and areas for improvement/optimized results. Quality Assurance in pharmacy claim adjudication to include plan design, pricing, clinical programs and pharmacy networks. Identified coding discrepancies, inaccuracies and unintended consequences by performing pre- and post implementation claim testing/validation and taking appropriate corrective action.

Proactively identified setup issues, escalating to proper department for immediate review/resolution. Built/maintained strong client/member relationships. Formulated procedural manuals for multiple departments. Member Advocate - November, 2011 to May, 2018

CVS Health - Scottsdale, AZ

Resolved highly escalated inquiries including Congressionals, social media and OPM complaints. Reviewed call recordings, providing coaching as needed. Collaborated with other departments to meet contractual obligations and anticipate future client goals. Skip Trace Investigator, Collection Specialist - April, 2008 to February, 2010 USAA - Phoenix, AZ

Located customers using private databases, public records and advanced skip tracing tools. Processed overrides and exceptions for financial hardships. Provided in-depth up-training to team members.

References available upon request.

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