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Citronelle, AL *6522 Phone: 407-***-**** E-mail Address: adtbeh@r.postjobfree.com

VANESSA A. STRAFFORD

Education and Training

Texas Pre-license 40-Hour Training in Classroom & Exam Completed, October 2022

New Adjuster Training Program 110-Hour in Classroom, October 2022

Professional Scoping & Xactimate 70-Hour in Classroom Training, Month 2021

Associate Degree, Florida Technical College, June 2005

Introduction to Health Care 90 Hour Training, March 1997

Nursing Assistant, 120-Hour Training, April 1997

Home Health Aide 45-Hour Training, May 1997

Patient Care Assistant 107-Hour Training, June 1997

Experience

2021-2022 Kroger Specialty Pharmacy-Benefits Investigator 2

2018-2020-Acaria Health Specialty Pharmacy. Lead intake and insurance coordinator

2014-2018-Acaria Health Specialty Pharmacy. Insurance Verification Coordinator

2013-2013-Randstad. CuraScript Specialty Pharmacy. Eligibility & Insurance Specialist, Benefits investigator

2008-2012-Aetna Specialty Pharmacy. Care Management Associate. Utilization Management

Manage the workflow of the image indexing, intake prep and/or insurance verification teams and ensure quality output. Assist with developing and administering all training related to the department as well as performing quality audits. Assist various vendors such as physician offices, pharmacies, and patients in verifying medical and pharmacy benefits. Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures. Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies. Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs. Handle inbound calls from patients, physician offices, and/or insurance companies. Reviewed clinical information to complete prior authorization approvals or denials.

Strengths

Strong leadership skills-maintain near-term flexibility while managing for the long-term goal

Sets and pursues aggressive goals to reach peak performance

Exceeds expectations-accepts personal accountability to exceed expectations and holds others to the same standard

Embraces creativity-promote and enable continuous development of self and others.

Respectful of institutional policies-able to change behavior and thoughts to align with the mission of the company

Exhibiting excellent customer service and people skills-build strong relationships with customers and partners, internal and external

A positive professional attitude

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