Data Entry Clerk
Resume:
*************@*****.*** ***** Parks Farm Ln., Charlotte, NC
28277
https://www.linkedin.com/in/kellyamclu
cas-85253b324
SUMMARY EXPERIENCE
Detail-Oriented Administrative Professional with proven success in remote work
Senior Patient Access Consultant Reimbursement Specialist
Nov 2023 — Aug 2024
environments, leveraging advanced
communication and interpersonal skills to foster dynamic team collaboration.
Demonstrates a strong commitment to continuous learning and adaptability, ensuring timely and effective contributions to organizational growth. Eager to apply
innovative thinking and strategic insight to drive success and development within the organization.
SKILLS
Microsoft Office, Management, Team Leadership, Administrative support, Patient Relations, Regulatory Compliance, Critical thinking and analysis, Communication, Data Analysis, SaaS, Creativity, Initiative, Quality Control, Digital Documentation, ICD-10 Coding, Medical Terminology, PowerPoint,
eSign / eSignature, Digital Faxing, Customer Service, Epic, Problem-Solving, Time Management, Analytical thinking and innovation, Project Management, Salesforce, CRM, ERO/SAP Platforms, Workday,
Technology use, monitoring, and control, Cross-functional Teamwork, HIPAA Compliance, CPT Coding, Multitasking, Insurance knowledge of HMOs, PPOs, POS, EPOs, and indemnity plans, Workflow Automation, Call Contact Center, Familiarity with Medical third-party billing and coding, Workflow Automation, eSign, Fax over IP.
LANGUAGES
English Native.
Fluent in English, experienced in using Language Line Solutions to speak to alternate languages, enhancing
communication with diverse patient populations.
Cencora, f.k.a. AmerisourceBergen, Conshohocken, PA — Charlotte, NC (Remote)
• Dedicated Patient Access Consultant with over 7 years of experience in the biopharmaceutical industry, specializing in reimbursement strategies.
• Proven track record of enhancing patient access to essential therapies through comprehensive knowledge of insurance plans and payer policies.
• Aligned with a Field Reimbursement Manager to enhance patient access across 300+ practitioner sites in Charlotte, NC.
• Skilled in navigating complex reimbursement landscapes and ensuring compliance with healthcare regulations and guidelines.
• Experienced in building strong relationships with healthcare providers, patients, and payers to facilitate access to treatments.
• Resolved 98% of customer inquiries on the first call, contributing to a 99% increase in overall customer satisfaction.
• Adept at analyzing patient eligibility and identifying financial assistance programs to support underserved populations.
• Committed to educating patients and healthcare professionals on insurance coverage options and treatment pathways.
• Strong analytical skills used to develop data-driven strategies that optimize patient outcomes and access to medications.
• Utilized strong analytical and organizational skills to develop data-driven strategies, effectively managing schedules, documentation, and compliance processes.
• Utilized Salesforce to manage patient interactions, leading to an 87% increase in patient engagement.
• Reviewed and resolved problematic healthcare claims, Explanation of Benefits for Commercial health plans, Medicare, TriCare, VA Benefits, and Medicaid.
• Managed administrative aspects of patient access for NUCALA, including scheduling
prescription deliveries, coordinating with healthcare providers, and maintaining accurate
patient records.
Site Coordinator Sr. Patient Access Specialist May 2019 — Nov 2023 Cencora, f.k.a. AmerisourceBergen, Conshohocken, PA — Charlotte, NC (Remote)
• Effectively managed patient access for NUCALA, driving significant improvements in service delivery and patient enrollment.
• Developed strong partnerships with specialty pharmacies, ensuring efficient copay assistance and medication delivery.
• Conducted benefit investigations and prior authorizations, and prior authorization appeals, improving patient access to therapies by 100% through effective coordination with
insurance companies and healthcare providers.
• Led initiatives to analyze payer trends, reporting reimbursement delays to management for timely resolution.
• Streamlined prior authorization appeals, resulting in a higher approval rate and improved patient satisfaction.
• Employed Salesforce (CRM) to manage patient interactions, track outreach metrics, and contribute to team performance goals, resulting in an 87% increase in patient
engagement.
• Leveraged strong communication skills to coordinate services with field reimbursement and sales teams, achieving a 97% improvement in patient satisfaction by ensuring timely
and effective communication.
• Collaborated extensively with the Provider Enrollment Team on Annual Reverification to expedite benefit investigations for patients and providers.
• Engaged empathetically with patients to navigate reimbursement challenges, demonstrating a commitment to personalized patient care.
• Managed adverse drug event reporting and product quality complaints, maintaining strict confidentiality and compliance with pharmaceutical regulations.
PATIENT ACCESS SPECIALIST (PAS)
CONCENTRATED WITH THE ACCESS PROGRAM
May 2019 — Nov 2019
Cencora, f.k.a. AmerisourceBergen, Conshohocken, PA — Fort Mill, SC
Leading a group of 10 Contingent Patient Access Specialists assigned strictly to the NUCALA Access Program (Self-Administration of NUCALA) team.
Successfully led a team of specialists to foster a customer service-oriented culture, resulting in a measurable increase in team performance metrics.
Monitored and escalated application issues, ensuring timely resolutions for patients transitioning from clinical trials.
Dedicated member of the HES/EGPA/Nasal Polyps team; using a tracking spreadsheet that allows the client to track the progress of the HES Patients through their transition
from the clinical trial and ensuring they have access to NUCALA through either their private commercial insurance or enrolling the patient for the Patient Assistance Program.
Led a cross-functional team of 10 members, encouraging professional growth and successfully advocating for six team members to achieve full-time positions.
Fostered a customer service-oriented culture within the team, enhancing overall patient experience.
Conducted continuous training and facilitated firsthand learning sessions with my team to ensure adherence to schedules for patient Self-Administration Injections, under program
guidelines.
Objectively worked to initiate training materials, crossword puzzles, Bingo, and Wheel of Fortune-type engagements specific to the FRM (Field Reimbursement Manager) Ways of
Working requirements for the Contingent Team assigned to the NUCALA Access Program.
Completed New Hire Onboarding regimens, including getting systems set up, telephone extensions, and copying necessary forms for Human Resources.
Built within the team a WOW-based customer service mindset advocate with a one-touch problem resolution goal.
Generated reports daily to ensure my group of PASs were up to date on new applications received based on a regional alignment to Field Reimbursement Managers.
Fax Reviewer, Benefit Verification Specialist, Credentialing Team
AmerisourceBergen, Conshohocken, PA
Oct 2018 — Feb 2019
Played a pivotal role in enhancing the efficiency of patient benefit verifications and credentialing processes.
Conducted comprehensive quality analyses that increased credentialing success rates for Benefits Verification Specialists.
Utilization of the Online Benefit Verification Tool, Med Connect, to assemble patient benefit information for Commercial Healthcare, Medicare, Medicaid, and Tricare Health
Insurance Programs.
Provide feedback and coaching to associates on potential data integrity errors during the new hire Benefit Verification Specialists Credentialing Process
Maintained meticulous records, ensuring accurate and detailed Summaries of Benefits for medical providers.
Gathered patient information from enrollment forms to be able to select the preferred
prescription and delivery method that would allow for asking pointed questions relevant to
the site of service, patient costs, and benefits specific to the medication the patient needs.
Optimized data entry processes, enhancing accuracy in patient benefit summaries and significantly reducing processing errors.
Medicare, Medicare Part D, Medicare Managed Care, Medicaid, TriCare, Veterans Administration Benefits, and Commercial Healthcare Payer knowledge.
EDUCATION
Health Information Management Apr 2022 — Present Rasmussen University — Fort Myers, FL
Dean's List, Honor Roll
Hospital Unit Secretary - Certificate Sep 2010 — Dec 2010 Central Piedmont Community College — Charlotte, NC
Medical Terminology - Certificate Jan 2010 — May 2010 Central Piedmont Community College — Charlotte, NC
Computerized Court Stenography General Studies Sep 1986 — Present University of Cincinnati — Cincinnati, OH
High School Diploma Aug 1982 — Jun 1986
Ross Senior High School — Hamilton, OH
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