ANA TWIDLE
Plainfield,USA
Summary
Results-driven reimbursement and patient access professional with over 2 years of experience in seamlessly facilitating patient onboarding, insurance verification, and reimbursement processing. Proven track record in optimizing operational efficiency and reducing costs through meticulous attention to detail and adherence to industry regulations. Adept at collaborating with cross-functional teams to streamline processes and enhance the overall patient experience. Committed to delivering exceptional service while maintaining a strong focus on accuracy and compliance.
Overview
7
7
years of professional experience
Work History
Pharma Support Services Specialist (Specialty Pharmacy)
Option Care Health
02.2024 - Current
- Communicate regularly with assigned program(s) representatives, FAS (Field Access Representatives) AE (Account Executives) HUB and social workers to provide necessary product support.
- Work alongside external and internal operational partners to drive implementation and coordination of pharma programs (Rare and Chronic Diseases).
- Communicate with clinical team and project managers about program updates and provide possible solutions.
- Through regular collaboration and data sharing, facilitate an understanding of market trends and customer needs to our pharmaceutical partners.
- Deliver engaging and informative presentations to our stakeholders effectively communicating key insights and trends.
- Handle outbound and inbound calls from healthcare practitioners and customers and triage to the appropriate department when necessary.
- Achieve and exceed monthly/quarterly referral targets and copay assistance enrollments set by Vice president of Pharma Program Support.
- Participate in bi-weekly teams calls with stakeholders and actively contribute to strategic discussions providing critical insight and expertise to drive solutions that meet customer needs and advance business objectives.
Revenue Cycle Specialist (Specialty Pharmacy)
Option Care Health
04.2023 - Current
- Assist with medical necessity documentation to expedite authorization approvals and ensure that appropriate follow up is performed.
- Review accuracy and completeness of information requested and ensure that all supporting documents are received.
- Manage correspondence with insurance companies and physicians as required.
- Document all prior authorization information including approval dates, prior authorization reference number, visits, doses, and units approved in CPR+.
- Proactively request prior authorizations that are due to expire within 30 days.
- Consult with supervisor or pharmacist to obtain clearance that treatment regimen is appropriate.
- Secure patient’s demographics and medical information by using discretion and ensuring that all procedures meet HIPAA compliance and regulations.
Revenue Cycle Specialist
Sutherland Healthcare
05.2021 - 11.2021
- Contacted insurance carriers to discuss policies and individual patient benefits.
- Posted payments to accounts and maintained records.
- Communicated verification and authorization status updates with the Revenue Cycle department to facilitate decision-making for patient admissions and insurance coverage.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Trained new staff on current, correct insurance verification procedures.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Established and maintained relationships with insurance providers for productive communications.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Generated reports to track insurance verifications and claim progress.
- Performed various administrative tasks by filing, copying and faxing documents.
- Assisted with medical coding and billing tasks.
- Prepared and processed patient referrals and transfer requests.
- Processed medical insurance claims and payments.
- Contacted insurance companies to achieve accurate and timely payments.
Patient Navigator
Ocean Health Initiatives
09.2018 - 04.2019
- Streamlined appointment scheduling, reducing waiting times and improving patient experience.
- Served as an advocate for vulnerable populations within the healthcare system, addressing disparities in access to care and treatment outcomes.
- Enhanced patient compliance with treatment regimens through motivational interviewing and supportive counseling.
- Facilitated access to community resources for patients, enhancing their overall well-being and support network.
- Assisted patients in overcoming barriers to care, such as transportation, language, and financial challenges.
- Educated patients on insurance and healthcare plans.
- Liaised with social services to provide holistic support for patients, addressing both health and social needs.
- Collaborated with insurance companies to clarify coverage and reduce financial burdens for patients.
Education
Bachelor of Science - Health Administration Services
Keiser University
Fort Lauderdale, FL05.2022
Skills
- Strong customer service skills
- Strong interpersonal skills
- Good decision-making skills
- Good analytical skills
- Ability to communicate effectively in writing and orally
- Ability to resolve customer issues quickly and creatively
- Strong organizational skills
- Attention to detail
- Basic knowledge of Microsoft Word
- Basic knowledge of Microsoft Excel
- Strong communication skills
- Good Telephone Etiquette
- Multitasking Abilities
- Planning and Coordination
- Organization and Time Management
- Problem-Solving
- Ability to build and nurture strong collaborative relationships
- Knowledge of ICD 10
- Knowledge of CPT
- Medicare and Medicaid reimbursement knowledge
Spanish
Native Speaker
Languages
Spanish
Native or Bilingual
Timeline
Pharma Support Services Specialist (Specialty Pharmacy)
Option Care Health
02.2024 - Current
Revenue Cycle Specialist (Specialty Pharmacy)
Option Care Health
04.2023 - Current
Revenue Cycle Specialist
Sutherland Healthcare
05.2021 - 11.2021
Patient Navigator
Ocean Health Initiatives
09.2018 - 04.2019
Bachelor of Science - Health Administration Services
Keiser University
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