Customer Service Pharmacy Technician

Objective

To secure a position in a professional environment where my customer service skills and expertise can be utilized to improve customer satisfaction.

Skills Summary

Customer Service

Collections

Pharmacy Technician

Credit Analyst

Bookkeeping

Professional Experience

Mercy Hospital-Inpatient Eligibility Specialist

Interviews uninsured / under-insured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance.

Assisting patients in hospital rooms with the application processes to facilitate accurate and appropriate application submission.

Build a positive relation with the patient and communicate of the eligibility process and benefits of having Medicaid coverage.

CVS-Benefits Verification Specialist Saint Louis, MO 03/2021-10/2024

Verify customer benefits and eligibility according to company standards and procedures.

Respond to customer inquiries and provide customer service support in a timely and effective manner.

Maintain up-to-date knowledge of benefit plans and eligibility criteria.

Enter and update customer information into the company system.

Collaborate with other departments to ensure customer needs are met.

Monitor and track customer accounts and benefit plans.

Assist in troubleshooting and resolving customer benefit-related issues.

Document customer interactions and transactions.

United Biosource Corporation-Case Manager Saint Louis, MO 01/2021-02/2021

Provide day-to-day case management oversite and coordination of assigned caseload to ensure parties responsible for tasks are completing them timely, as well as act as primary resource for patients, healthcare providers and field reimbursement.

Ensuring prior authorizations, re-authorizations and appeals are obtained timely, as well as ensuring accurate documentation of payer information and patient status.

In addition, responsible for completing a pre-screen to determine eligibility for additional services such as injection services, co-pay mitigation, and patient assistance programs (PAP), if applicable.

Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.

Urology of St. Louis-Medical Billing Specialist Saint Louis, MO 05/2019-11/2020

Verify validity of account discrepancies by obtaining and investigating information from insurance companies and customers.

Monitor patient account details for non-payments, delayed payments and other irregularities.

Review charge tickets and resolve problems concerning the recording of provision of services rendered which impact on ability to collect charges.

Daily charge entry of office visits.

Prepare and submit clean claims to insurance companies either electronically or on paper.

Identify and resolve patient billing complaints.

May be asked to obtain prior authorization for procedures or medications.

Communicate with patients via phone, mail, or personally.

Protect organization’s value by keeping information confidential.

BJC HealthCare-Representative Patient Accounts-RCM Saint Louis, MO 06/2017-05/2019

Provide support Revenue Cycle Management in the area of Revenue Management patient accounts.

Ensure best practices are adopted in the area of pre-billing, cash posting, refund/credit balancing processing, billing, and monitoring claim status.

Provide professional communication with patients, payers, physicians, and other parties.

McKesson – Account Receivable Specialist I Saint Louis, MO 06/2015-06/2017

Follow up of outstanding A/R all payers and/or including self-pay and/or including resolution of denials.

Responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payments on accounts and identify issues or changes to achieve client profitability

Work EDI transaction and ERA files, including reconciling carrier submissions, edits and rejection reports.

Ability to research and resolve accounts appearing on Delinquent Insurance Report, Collections Ledger and Government Payor report as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement.

Express Scripts-Reimbursement/Claims Specialist Saint Louis, MO 03/2015-06/2015

Conduct benefit investigation, verify insurance benefits for patients and physician office, and submit and obtain prior authorizations as required by payer.

Obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval.

Accurately enter and maintain data as required in the client database and patient files and utilize the client database to monitor outstanding items on each client case file.

Provide coordination of order for product, shipment of product, and therapy initiation with pharmacy and patient.

Dohmen Life Science Services- Patient Service Coordinator Chesterfield, MO 02/2014-03/2015

New patient on-boarding and creating patient profile, including insurance information.

Benefit investigation and benefit explanation to patient, initial and ongoing.

Obtaining and maintaining Prior Authorizations.

Creating patient orders and associated prescription entry for new and refill prescriptions.

Communications with prescribers, including requesting new prescriptions.

Billing RX drugs and administration supplies.

Assist patients with financial assistance as needed.

Arrange all necessary documents and materials for shipments initially and ongoing.

First point of contact for patients.

Schnucks Pharmacy - Pharmacy Technician Bridgeton, MO 04/2012 -02/2014

Provide friendly and courteous service to patients.

Process telephoned refill requests directly from patients.

Gather pertinent health or personal information from patients that is needed to process prescriptions.

Communicate with the doctor’s office regarding new prescriptions.

Enter prescription data into the computer.

Express Scripts – Pharmacy Technician Maryland Hgts, MO 11/2007-3/2011

Take incoming calls from patients interested in converting their maintenance medications to home delivery.

Adjust patients’ accounts if they are unable to obtain their medication from the retail pharmacy.

Work directly with the pharmacists and doctors’ offices to get the patients’ medications.

Contact doctors’ offices to verify patients’ relationships with the doctors.

Fax prescriptions to doctors’ offices to expedite the patients’ medications.

Communicate with the pharmacists to authorize patients’ medications.

US Bank – Collector Saint Louis, MO 12/2004-03/2007

Answer incoming calls regarding credit card accounts.

Collect assigned delinquent accounts by reviewing documentation, contacting clients via phone or written correspondence.

Arrange repayment schedules in order to minimize loss to the organization.

Received the top bonus structure each month I was employed for collecting the most bad debts from customers.

Sysco Foods of – Credit Analyst Saint Charles, MO 07/2002 – 07/2003

Handled the investigation of commercial accounts for credit terms and limits.

Reviewed aging analysis to collect past due accounts and resolve discrepancies.

Resolved all customer inquiries and issues.

Angelica Image Apparel – Credit Analyst Saint Louis, MO 04/1999 – 07/2002

Management of all internal and outsourced collection accounts.

Updated and reviewed creditworthiness of all accounts.

Enforced credit and collection policies and procedures.

Handled customer escalations and queries, payment disputes, and write off and budget issue.

Liaison between all departments and management.

Education

O’Fallon – Diploma – 1988

Other training and certifications

Better Family Life, Inc., Project R.E.S.P.E.C.T., 03/1999

Making Patient Connections Workshop 10/2010

References

Available upon request

Contact this candidate