ALEIA SWANSON
Casselberry,USA
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
11
11
years of professional experience
Work History
Pharmacy Technician
Walgreens
06.2023 - 06.2025
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
- Collected co-payments or full payments from customers.
Reconsideration Analyst (Contract)
Innovative Solutions & Support Inc
10.2022 - 05.2023
- Identified and resolved problems through root cause analysis and research.
- Validated results and performed quality assurance to assess accuracy of data.
- Applied knowledge of data modeling and statistical analysis to note trends and draw conclusions.
- Performed system analysis, documentation, testing, implementation and user support for platform transitions.
- Analyzed program data to provide input for key decision making and strategic planning.
- Gathered, organized and input information into digital database.
- Worked flexible hours across night, weekend and holiday shifts.
Case Manager
United BioSource Corporation
05.2018 - 08.2022
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Helped patients receive appropriate, high-quality care with reasonable results.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
- Evaluated treatment plans against individual goals and healthcare standards.
- Updated time, and systems
- Helped patients gain access to rehabilitation programs, and services.
Customer Service Support Representative (Contract)
American Safety Council
04.2017 - 10.2018
- Carried out day-day-day duties accurately and efficiently.
- Assist customers with signing up with online courses for various programs.
- Receive 100+ inbound calls daily from customers looking to enroll into programs.
- Troubleshoot issues with online course programs.
- Email and mail out certificates upon request.
- Worked flexible hours; night, weekend, and holiday shifts.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.
- Maintained energy and enthusiasm in fast-paced environment.
Reimbursement Specialist
Omnicare
02.2016 - 04.2017
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
- Prevented delays and claim denials by correcting information prior to submission.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Handled account payments and provided information regarding outstanding balances.
- Used data entry skills to accurately document and input statements.
Benefit Specialist
United Healthcare
02.2014 - 04.2016
- Updated personnel handbooks and individual records to keep filed accurate and detailed.
- Researched and resolved routine and complex issues.
- Processed eligibility and benefits verification and authorization requests.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Followed up on denials, late payments, extensions and other special circumstances.
- Acted as subject matter expert, answering internal and external questions and inquiries.
- Maintained confidentiality of patient finances, records and health statuses.
- Prior authorization request.
- Responded to customer calls swiftly to resolve issues and answer questions.
- Maintained high standards of customer service by building relationships with clients.
Education
High School Diploma -
Colonial High School
Orlando, FLSkills
- Case management
- Written and verbal communication
- Microsoft excel
- Documentation and paperwork
- Critical Thinking
- Active Listening
- Major medical & PBM
- Oncology PAP Assistance
- Ability to handle irate customers
- Medical terminology knowledge
- Professional telephone demeanor
Timeline
Pharmacy Technician
Walgreens
06.2023 - 06.2025
Reconsideration Analyst (Contract)
Innovative Solutions & Support Inc
10.2022 - 05.2023
Case Manager
United BioSource Corporation
05.2018 - 08.2022
Customer Service Support Representative (Contract)
American Safety Council
04.2017 - 10.2018
Reimbursement Specialist
Omnicare
02.2016 - 04.2017
Benefit Specialist
United Healthcare
02.2014 - 04.2016
High School Diploma -
Colonial High School