Shristi kanta

*** ********* ***** ***** *** Francisco CA 94080 / 650-***-**** / adu49p@r.postjobfree.com

Skills Summary

Experience communicating with medical professionals (physicians and pharmacists) as well as patients and various insurance companies to troubleshoot benefit issues.

Reimbursement Counselor professional with 8+ years of experience in the Healthcare industry including strong knowledge of medical terminology while fully trained in HIPAA compliance.

Key strengths includes ability to meet and exceed targets, a knack for managing on time projects and the ability to maintain productivity levels.

Managing change – Accepts change as a positive and adapts accordingly

Highly proficient in MS Office software (Word, Excel and Outlook) as well as web-based software for insurance verifications and benefits summary.

Understands reimbursement/funding resources and how to access these resources.

Ability to work collaboratively in a team structure and responsibly delegate next steps to appropriate team members.

Demonstrates effective problem solving and excellent customer service.

Exceptional attention to detail.

Able to work effectively under pressure and prioritize tasks.

Able to follow written Standard Operating Procedures.

Experience

Sutter Health

Lobby Screener (October 2020 – November 2020)

Ensures all patients, visitors, and vendors are wearing appropriate facial coverings.

Screen patients entering the lobby for symptoms of respiratory illnesses such as fever or cough

Direct patients to the proper department based on the screening rubric

Update all necessary information in EPIC software for all patients visit.

Manage the pharmacy line and screening of patients picking up medications.

Prior experience in fast paced and large volume patient care/customer service

Ability to establish and maintain effective working relationships with patients, employees, and the public.

Knowledge in EPIC software

Genentech

Foundation Specialist [March 2017- March 2020]

Provides customer focused support to patients and providers

Assists patients and providers in enrollment process for assigned product

Evaluates patient eligibility across key criteria and communicates determinations

Embeds a culture of compliance by ensuring self, colleagues and team members are adhering to laws, regulations, and policies that govern Foundation conduct

Actively supports product launches, line extensions and formulation changes

Works collaboratively with peers to move casework forward.

Coordinates delivery of Genentech product following all shipping policies and procedures

Focus on doing what is right for patients – strong patient orientation.

AmerisourceBergen Inc. (Lash Group)

Reimbursement counselor [November 2009- March 2017]

Process patient benefits investigations/verifications, prior authorizations, Insurance networks, Specialty Pharmacies, Pharmacy Benefit managers, Major Medical.

Initiate Co-pay assistance for patients and tracking Prior Authorization and prescription order status with payers and pharmacies.

Provide exceptional customer service to internal and external customers; resolve any customer requests in a timely and accurate manner; escalate complaints accordingly.

Maintain frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.

Report any reimbursement trends/delays to supervisor (e.g. billing denials, claim denials and payments, etc.).

Coordinate with inter-departmental associate to obtain appropriate medical records as they relate to the reimbursement process.

Maintain confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

AmerisourceBergen Inc. (Lash Group)

Program support specialist [September 2008- November 2009]

Maintained effective systems to support the timely release of accurate information to diverse clients.

Responsible for the intake of all program specific correspondence including mail and faxed documents.

Logged information into appropriate database and triaged all program specific mail to the appropriate reimbursement counselor.

Distributed reports daily disseminating information to appropriate distribution vendors’ reimbursement counselors and team leaders.

Stanford University Medical Center

Administrative assistant [March 2007- September 2008]

Prepared correspondence, memos and any necessary documentation.

Scheduled travel and transportation requirements, prepared and maintained expense reimbursements.

Assisted in answering and follow-up of telephone messages, faxes, and other correspondence.

Followed up on requests made by vendors, investors, business partners, insurance brokers, legal firms and other company personnel.

Managed daily requirements of the office/function, including filing system, meeting minutes, printing and copying reports, assembling and packaging reports, as well as maintaining the office environment in a professional and tidy manner.

Education

Boston Reed College [2009- 2010]

Clinical Medical Assistant Certificate

Career and Management Training College [2009- 2010]

Computer Studies Certificate

Advanced Diploma in Business Administration, Management, Computing and Travel and Tourism.

Reference:

References upon request

Contact this candidate