Eligibility Specialist Reimbursement

Nancy Collins-Tanner

**** ***** **

Orlando, Fl *2826

407-***-**** (Home)

*******@***.***

Employment

Kroger Specialty Pharmacy July 2018-Present

Lead Reimbursement Specialist

Responsible for assisting 11 Collectors in problem resolutions

Responsible for both PAP and Patient AR

Assists in training of new employees

Works closely with copay assistance programs

Completes rebilling if needed on denied claims.

Works closely with patients to get bills paid

Runs several different reports for manager

Works closely with finance at month end closing.

Works remotely 5 days a week

Accredo Pharmacy May 2005-July 2018

Accounting Specialist11- Government Collections

Responsible for managing Medicare claims

Responsible Completes all appeals as needed

Completes adjustments

Makes sure all Medicare claims are sent to secondary payers

Works closely with Medicare and other insurances to ensure prompt payments of claims

Assists in the training of new team members

Assists all team members in problem resolution

Accounting Specialist 11- Refund Coordinator

Member of the Emerging Leadership Program

Works credit balances for all ESI plans.

Completes refunds and adjustments as needed

Assists with special projects as needed

Have brought down credit balances since taking this position.

Accounting Specialist

Billing and collection coordinator for Express Script account.

Handles Express Script account with totals over $70 million dollars a month.

Coordinates and handles projects for ESI corporate finance for problem accounts.

Assist in training of new hire trainees in the PBM department.

I am a liaison for express script accounts for many departments needing assistance.

Patient Care Coordinator

Support 80 customers per day on average.

Coordinate medication approvals between patients and insurance companies.

Manage requests from several incoming phone queues.

Assisted in training all new personnel who were hired into the department.

Assisted patient in obtaining financial assistance from outside entities.

Department of Children & Families- Dec 2001-Feb 2005

Certified Public Assistance Eligibility Specialist

Managed a case load of 400+ recipients of Medicaid, Food Stamp and Cash Assistance programs for the state of Florida.

Problem Resolution Specialist for exceptional client issues.

Coordinated services with FEMA and clients during the aftermath of Hurricanes Charley, Frances, Ivan and Jeanne in Florida in 2004.

Completed bill tracking for Medicaid’s share of cost program for prescription medications for clients.

Developed training programs for clients to meet their volunteer and work obligations.

Education

Lake Shore Central High School – Graduated 1978

Erie Community College- Addiction Counseling Classes

Hilbert College- Human Services Courses

University of Phoenix- Bachelor of Science in Business/Accounting

Grand Canyon University- MBA in Health care Administration

References available upon request

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