JoAnn Horne

• Conducted thorough analysis of medication access obstacles and devised actionable solutions to streamline patient care processes.
• Developed and implemented streamlined workflows for medication access, ensuring efficient adherence evaluations and fostering prompt interactions among patients, prescribers, and physician office teams.
• Achieved significant process efficiency by applying advanced knowledge of third-party reimbursement and medical terminology. Forged impactful partnerships between pharmacists and physicians to enhance patient support services.
• Applied advanced communication techniques and analytical reasoning to identify and resolve multifaceted challenges.
• Developed and implemented effective communication strategies to ensure alignment between internal stakeholders, external customers, and physician office personnel.
• Identified weaknesses in insurance verification methods and instituted systematic improvements to optimize accuracy and efficiency.
• Developed and delivered training sessions focused on access protocols and systems to cultivate collaboration among new staff members.
• Developed instructional materials that equip staff with essential skills for effective patient access and navigation within the system.
• Trained new staff on access protocols and software systems, fostering team efficiency and knowledge retention.

• The prior authorization specialist is responsible for coordinating all aspects of the prior authorization process, including insurance verification, formulary reviews, gathering necessary clinical information from electronic medical record, and timely communication with patients, prescribers and physician office staff.
• Candidates should possess knowledge of third-party reimbursement regulations and medical terminology as well as seek out assistance from a pharmacist or physician as necessary.
• Success in this role will require strong communication, interpersonal, and problem-solving skills.
• This person should be able to interact and communicate effectively with internal and external customers, physician office staff, and all members of the organization.

• The prior authorization specialist is responsible for coordinating all aspects of the prior authorization process, including insurance verification, formulary reviews, gathering necessary clinical information from electronic medical record, and timely communication with patients, prescribers and physician office staff.
• Candidates should possess knowledge of third-party reimbursement regulations and medical terminology as well as seek out assistance from a pharmacist or physician as necessary.
• Success in this role will require strong communication, interpersonal, and problem-solving skills.
• This person should be able to interact and communicate effectively with internal and external customers, physician office staff, and all members of the organization.
• Bethesda North Impatient Pharmacy

• Under the leadership of Central Business Office (CBO) management, the customer service specialist provides supportive assistance to patients regarding billing concerns/issues.
• This position is responsible for answering incoming phone calls from patients and resolving billing concerns in a timely, accurate manner.
• Provided supportive assistance to patients regarding billing concerns/issues.
• Answered incoming calls from patients and return calls, addressing patient's questions or concerns in a professional and ethical manner.
• Interacted with patients, family members, external healthcare related companies, law firms, co-workers and other MH employees to resolve billing issues or concerns.
• Assessed the nature of incoming calls and identifies and completes appropriate action in a prompt manner.
• Researched specific transactions on a claim.
• Sent patient statement via mail.
• Rebilled claims.
• Pulled an explanation of insurance benefits for payment information.
• Request adjustment on a claim.
• Sent itemized statements upon customer’s request.
• Sent a financial Aid application to a patient or refer to Financial Counseling, as appropriate.

GPA: 3.2