Patient Account & Enrollment Specialist Resume

Vickie Burton

Durham, NC ***** 919-***-**** ************@******.***

PROFESSIONAL SUMMARY

Detail-oriented Patient Account and Enrollment Specialist with extensive experience in healthcare billing, copay assistance programs, and pharmacy claims processing. Skilled in resolving billing discrepancies, reviewing Explanation of Benefits (EOBs), educating patients on payment options, and collaborating with pharmacies to ensure accurate claim processing. Adept at working independently in remote environments while delivering exceptional customer service and maintaining account accuracy.

PROFESSIONAL EXPERIENCE

Member Enrollment Coordinator (Remote)

PrudentRx 2023 – 2025

Enroll patients in Copay Assistance Programs (CPA) and verify eligibility requirements.

Resolve billing discrepancies and ensure accurate application of payments and adjustments.

Educate patients on specialty medications and out-of-pocket costs.

Collaborate with pharmacies to obtain paid claims and process escalations.

Utilize Oracle Systems and Epic TrialCard for accurate account documentation.

Handle inbound/outbound calls to resolve patient account balance inquiries.

Achievement: Assisted 50+ patients weekly with enrollment and copay issues, improving timely payment compliance.

Patient Experience Specialist

Cary, NC 2019 – 2023

Processed pharmacy claims for HIV and HPV medications, ensuring accuracy and compliance.

Investigated and resolved payment discrepancies and claim rejections.

Assisted members with program enrollment and copay assistance applications.

Educated patients on billing statements and payment options.

Achievement: Resolved over 200 escalated billing issues per year, improving patient satisfaction and account accuracy.

Customer Care Specialist

Conduent Raleigh, NC 2016 – 2018

Provided support for Humana Pharmacy benefits, insurance coverage, and billing inquiries.

Reviewed account activity to verify benefit coverage and payment accuracy.

Assisted with prior authorizations, overrides, and vacation supply requests.

Processed payments and coordinated prescription transfers.

Facilities Manager

BOOZ RTP, NC 2015 – 2016

Managed office inventory, purchase orders, and facility maintenance.

Monitored incoming/outgoing mail and maintained security logs.

Provided front-desk support and coordinated conference room scheduling.

EDUCATION

Durham Technical Community College — Durham, NC

SKILLS

Healthcare Billing & Claims Processing

Patient Account Resolution

Copay Assistance & Enrollment

Epic & Oracle Systems

Lotus Notes

Microsoft Office Suite (Word, Excel, Outlook)

Data Entry & Records Management

Customer Service & Office Management

Inventory & Human Resources Support

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