Verification Specialist Customer Service
Resume:
Melanie Koch
Education: Bachelor of Science in Health Science
Lock Haven University
Work Experience: ConnectiveRx
Benefit Verification Specialist
Pittsburgh, Pennsylvania, 15106
● Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients to process patient prescription needs successfully and demonstrate excellent customer service to patients, healthcare professionals and insurance carriers
● Collect the appropriate information needed to ensure insurance coverage for patient medication orders and document in computer systems
● Process patient prescription needs successfully, reduce exposure to adverse events, and demonstrate excellent customer service to patients, healthcare professionals and insurance carriers
● Contact insurance carriers to resolve insurance coverage issues
● Effective communication with patients/families, physicians, third party payors, pharmaceutical manufacturer representatives.
● Represents the company in a competent, professional and responsive manner. Interacts with the operations and quality team consistent with team-building and professional culture established by the company.
● Coordinates the care of patient to assure access to pharmacy products and services. Maintains high quality customer service standards in compliance with federal and state regulations and guidelines.
● Works in collaboration with team members and management to respond to the requests. WV Department of Health and Human Resources
Economics Social Worker
16th Street Wheeling WV, 26003
● Take applications interviews client to gain overview of client financial resources and social circumstances pertinent to eligibility for services; performs in-depth interview to establish eligibility for specific programs and benefits, such as the West Virginia Supplemental Nutrition Assistance Program (SNAP) and medical services.
● Determining eligibility for and managing a caseload for a variety of economic assistance programs.
● Responsible for conducting personal interviews with clients, evaluating, and verifying personal, financial and social information, determining eligibility for services, maintaining a client caseload and referring clients to other social service and community service agencies when appropriate.
● Takes calls from clients and public and sees "walk-ins" requesting information on economic service.
● May obtain repayment from clients who have been issued economic assistance erroneously.
References Available Upon Requests
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