John F Nembhard Sr.

**** ***** **** ** *** ***

Oveido, Florida 32765

240-***-****

aduo0o@r.postjobfree.com

Profile:

Extensive experience in successfully creating, implementing, and managing short and long term goals, as well as managing the day to day operations of large-to-medium sized businesses that included sales and consistently improving the overall customer experience

Experienced in assessing customer needs and developing strategies to meet those needs.

Accustomed to working under pressure, goal-oriented and self-motivated.

Effective time-management, communication, team-building and problem-solving skills. Proven track record of successfully implementing regional and divisional goals and objectives.

Job Experience:

Centene- Insurance Verification July 2022- August 2022

Verified insurances/coverage

Update system on patients information

Inbound and out bound calls

Excellent customer service

TN4GOV-Adjudicator/Customer Service May 2021-July 2021

Inbound calls

Verify claimants information

Update information in system

Resolve any issues presented

Amerisourcebergen-Insurance Verification November 2021-December 2021

Outbound calls to insurance companies

Verify insurance coverage

Update system with updated information

Resolve any and all issues that may arise

Work remotely

AcariaHealth Specialty Pharmacy-Pharmacy Tech October 2019-April 2020

Responsible for inbound and outbound calls.

Verify insurances and Prior Authorizations, with Doctors offices and Insurance companies.

Place medical orders for deliveries.

Resolve and all issues that may arise.

Work remotely from home.

CVS Specialty Pharmacy-Insurance Verification February 2019-October 2019

Inbound calls in a timely manner

Verify insurance coverage

Call Insurance companies and Doctor office to gather needed information

Place orders for members

Give excellent customer service

Aecom-Customer Service/Data Entry September 2019-April 2019

Make outbound and take inbound calls.

Input data via email or direct from member.

Co-ordinate case managers with progress of each members issues

Resolve all issues that may arise.

Accredo/Surescript- Prior Authorization Tech September 2017-September 2018

Verify insurance coverage of patients, see if they have other insured assistants.

Call insurance companies and patients to obtain any and all information needed to complete orders.

Correct any and all issues on accounts.

Process orders, update authorizations.

Complete orders from fax, phone, and emails.

Comply to Hipaa guidelines.

Cigna Healthspring-Pharmacy Technician November 2015 — 2016

Order intake-completing inbound orders via fax or phone calls Cigna HealthSpring members and clinic physicians for therapies requiring prior authorization and investigation Calling/contacting medical offices to complete orders verifying all information

Ensure orders are completed within compliance regulations set by Medicare

Provide courteous, consistent, and professional contact end inquiries with physicians, clinical staff, and Cigna HealthSpring members

Receive and process telephone and fax requests from pharmacies and members related to the status of PA requests

Initiate calls to physicians when additional information is needed for required processing and adjudication of a PA requests in accordance with federal and department policies and guidelines Review requests create new cases for Medicare — Part D

Support Pharmacists in gathering additional information to support the decision making exceptions for requests

F&R Construction SVCs -Administrative/Customer Service Director August 2011 — November 2015

Performed data entry tasks to include order entry, bookkeeping, inventory, and shipping and receiving manifests

Developed and designed construction sales and promotional materials including print and internet ads

Developed and managed sates goats by implementing incentives, projects, and step goals in order to meet quarterly and yearly benchmarks

Maintained the phone-board, incoming calls, and customer requests

Recorded meeting minutes to include assigned tasks, timelines, expectations, subsequently follow up discussions, and establishing short and long term goals when necessary Assist the Vice President with daily planning of various inquires, inquisitions

Employee management to include providing incentives, ensuring morale and productivity

Provide exemplary service to client base in order to ensure high customer satisfaction,

Center for Vein Restoration-Database Manager July 2011 — August 2011

Informed and communicated with existing clientele and new subscribes regarding general services including inquires, inquisitions and promotions of various products and services

Created and maintained successful relationships and partnerships with clients for the organization by providing outstanding customer service via phone and through email communications

Provided skilled support for special projects and other duties as assigned

Responded and solve customer inquiries in an expedient manner

Promoted and sold various value-added/ancillary products and services

Followed up and communicated with spe cific teams and departments for escalated and resolutions of more high priority and c1 omplex inquisitions and problems

New Hampshire Pharmacy and Medical Supplies-Customer-Service/Fitter October 2002 — March 2011

Communicated directly with customers in an expedient fashion via telephone, electronically or in person to handle and resolve complaints as well as with inquires and inquisitions

Obtained and evaluated all relevant information to handle product and service inquires and issues

=b 4== 54ww3 Researched, obtained, and provided pricing and delivery information to middle and upper management in a prompt and accurate manner

Performed and verified new and existing client accounts which included processing orders, maintaining various forms, applications, and requests, as well as organized workflows to meet customer set timeframes

Recorded, filed, and archived details of inquires

Fielded comments and complaints as well as details of actions take and necessary follow up tests

Manual labor to include fitting compression stockings and various braces, and equipment assembly

Educated clients on use and functionality of medical equipment

Education:

Howard University School of Fine Arts, 1982 — 1984

Career Technical Institute, 2015-2016 (A+ Certification)

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