Aderilene Agrinsoni
Summary
Professional with experience in billing and account management. Skilled in handling complex billing issues, ensuring accuracy, and meeting deadlines. Strong focus on team collaboration and adaptability to changing needs. Reliable communicator and problem-solver with proficiency in billing software, customer service, and financial reconciliation. Prepared to deliver results and contribute effectively in fast-paced environment.
Overview
14
14
years of professional experience
Work History
Enrollment/Billing Representative
Carepath RX
Maitland, FL
03.2023 - Current
- Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and accurate payments.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Processed medical claims with accuracy and efficiency, ensuring timely reimbursement from insurance providers.
- Utilized billing software to manage accounts receivable and maintain accurate financial records.
Billing Coordinator
BioPlus Specialty Pharmacy
04.2022 - 03.2023
- Streamlined billing processes, enhancing accuracy and reducing discrepancies in patient accounts.
- Completed appeals of denied claims on patient bills.
- Established clear communication channels between departments to promote seamless coordination in all aspects of the billing process.
- Outbound calls to patients to reschedules medications and advise of delays when necessary.
- Ability to balance various tasks/responsibilities and work with minimal supervision.
- Researching and updating manufacturer copay assistance programs as needed and annually.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
Patient Access Coordinator/Pharmacy Technician
Kroger Specialty Pharmacy
01.2019 - 04.2022
- Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards.
- Update cases with detailed activity, communication and documentation for accuracy and workflow.
- Check insurance benefits for medication coverage, track progress, and maintain continued contact with patient.
- Maintain a current national and/or state registration, certification, or license.
- Prepare shipments appropriately to ensure drug stability during transit.
- Manages pharmacy stock, organizing and notifying inventory coordinators of any problems or concerns.
- Accept prescription, establishing billing/patient charges, interprets and enters information regarding the outpatient prescription.
- Assist in other pharmacy departments such as shipping and receiving/tracking medication deliveries and stock.
Medical Billing/Workers Compensation Collector/Trainer
RX Development Associates Inc.
06.2012 - 01.2019
- Developed training materials aimed at enhancing employee skills and knowledge retention.
- Examine state laws, statutes, and regulations regarding medical bills.
- Research and share knowledge for ever-changing state specific fee schedules.
- Medical and pharmaceutical billing and coding procedures (ICD9, ICD10, CPT and HCPCS).
- Collecting on delinquent accounts and accounts marked as uncollectible.
- Follow up on aging and delinquent accounts as well as active claims to ensure processing and payment.
- Negotiations with Third Party Administrators to have claims paid at an acceptable rate in a timely manner.
- Articulating accurate and complete appeals, emails and other correspondence.
Pharmacy Technician
CVS Pharmacy
06.2012 - 11.2012
- Front line customer service specialist and maintaining weekly/daily department reports.
- Financial transactions and medication dispensing with Pharmacist supervision.
- Assisting patients and physicians with questions by directing them to Pharmacist on site.
- Assisting Pharmacist with multiple duties as required.
- Checking in orders, pricing drug orders (except CII’s), maintaining inventory levels, removing any outdated and/or recalled merchandise, and any party transactions including the completion of any paperwork.
- General pharmacy department upkeep and maintenance.
Education
Associate of Science - Pharmacy Technician License & Certification
Winter Park Tech - Avalon Campus
11.2010
Skills
- Registered and Certified Pharmacy Technician
- Bilingual (Spanish/English)
- 60 WPM
- Proficient in MS Office Suite
- Proficient in EMR, Billing programs, medical terminology and medical billing and coding
- High quality, fast and efficient patient care and customer service
- Critical thinking and problem-solving skills
- Billing Systems: CPR, Caretend, RX Billing, CE2000, Homecare 360, and Medisoft
Timeline
Enrollment/Billing Representative
Carepath RX
03.2023 - Current
Billing Coordinator
BioPlus Specialty Pharmacy
04.2022 - 03.2023
Patient Access Coordinator/Pharmacy Technician
Kroger Specialty Pharmacy
01.2019 - 04.2022
Medical Billing/Workers Compensation Collector/Trainer
RX Development Associates Inc.
06.2012 - 01.2019
Pharmacy Technician
CVS Pharmacy
06.2012 - 11.2012
Associate of Science - Pharmacy Technician License & Certification
Winter Park Tech - Avalon Campus