Andrea Palm
McKeesport,PA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Hardworking and passionate job seeker with strong organizational skills eager to secure a position. Ready to help team achieve company goals.
Overview
13
13
years of professional experience
Work History
Benefits Verification Specialist
CVS Health
Monroeville, PA
06.2017 - Current
- BV for all Rare Disease Medications obtaining Prior Authorizations, Overrides follow ups on Prior Authorizations with Doctors Offices and with Insurance companies, worked with patients to obtain approvals for all billing and help with collections, assisted with copay assistance for patients
- Worked with Medicare and Medicaid patients obtaining Prior Authorizations and billing for Medications
- Work with Insurances to make sure Patients are in Network and can be billed by CVS
- I work with a Third Party Manufacture to ensure all Pts needs are taken care of for this RAD drug
- Set up nursing for this Medication and make sure Billing and Prior authorizations are obtained
- Worked the Mailbox taking care of BV needs adding Bill groups and CoPay cards and processing for accounts and ensuring a 0 balance of claims is done
- Emailing and asking for assistance with Account Managers and other Team supervisors to obtain the results that we need
- Work with billing to do back claims and clear collections of selfpay and old amounts that can be billed to other insurances or current insruances.
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
- Built relationships with vendors to foster quality service delivery.
Pharmacy Technician
Rite Aid
McKeesport, PA
04.2015 - 01.2017
- Assist pharmacy and front store customers with their questions and concerns
- Request additional help when needed to maximize customer satisfaction
- Maintain customer/patient confidentiality according to HIPAA and company standards
- Answer telephone with appropriate greeting
- Perform all functions and duties of a Pharmacy Service Representative to ensure prompt service in the Pharmacy Department
- Perform computer entry of prescription information including but not limited to: patient search, prescriber search, drug selection, prescription interpretation & entry, insurance billing and basic problem resolution
- Accept customer and prescription information required to process new and refill prescriptions, including refill authorization from doctor offices where permitted by state law
- Retrieve the appropriate medication from inventory where permitted by state law
- Create prescription labels and put them on prescription containers where permitted by state law
- Place medication into prescription containers where permitted by state law Complete paperwork related to filling prescriptions and input customer and prescription data into the computer system where permitted by law
- Assist with maintaining the Pharmacy department by keeping it clean and in order
- Assist in inventory management processes including: order review, inventory returns, restocking shelves, and physical inventory preparation
- Administer Rite Aid programs including: FlavoRx, Living
- More
- Reconstitute oral liquids where permitted by state law.
- Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Entered and processed patients' prescriptions into internal system.
- Collected co-payments or full payments from customers.
- Managed opening and closing duties for pharmacy.
- Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
AR Billing Specialist
McKesson Billing for Surgery
Pittsburgh, PA
12.2011 - 07.2013
- Handled all Denials for all Insurances
- I worked with Physician's offices and Facilities to obtain needed
- Medical Records and billing information
- I contacted patients to obtain information to insure proper billing
- Proficient in Microsoft and Excel
- Worked with the team to insure that all claims were completed within a timely manner to avoid adjustment
- Very detailed oriented, able to identify problems and find solutions
- Able to think outside the box to find patterns from insurances with denials
- I was able to work many work programs within a day to insure that work load was completed and correct
- I am able to Multi Task and change direction to work an urgent project without creating problems with my daily work load
- Left to work from home
- I wanted to be my own boss again
- Matched purchase orders with invoices and recorded necessary information.
- Entered figures using 10-key calculator to compute data quickly.
- Reconciled account information and reported figures in general ledger by comparing to bank account statement each month.
Liaisons Representative
Apria DME
Coraopolis, PA
06.2010 - 12.2012
- Handled all Medicare Denials, as a collector
- Worked with physicians and branches to obtain needed
- Medical Records qualifying patient's equipment
- Contacted Patients to obtain current Medicare information to insure proper billing
- Attended all training classes for 3 months learning the systems
- ACIS and APRIA
- Trained on Cute PDF faxing and receiving documents on my desktop
- Maintained productivity at 70 or more action codes per day
- Trained and use all Medicare websites to verify qualifications of Medicare patients
- Created productivity spreadsheets for our team showing and mapping improvement
- I am proficient in Microsoft and Excel and all Microsoft based programs
- Worked as a team to insure that all claims were completed within a timely manner to avoid adjustment
- Very detailed oriented, able to identify and resolve issues or locate documentation
- Working the Hold
- Reports for all Branches in Apria to resume billing creating revenue.
Education
Serra High School
Pittsburgh, PANo Degree - Microsoft Programs, Excel
Long Beach City College
1989
Skills
- Attention to Detail
- Training and Development
- Organization and Time Management
- Excellent Communication
- Dependable and Responsible
- Problem-Solving
- Critical Thinking
- Written Communication
- Good Telephone Etiquette
- Analytical and Critical Thinking
- Teambuilding
- Active Listening
- Planning and Coordination
- Interpersonal Communication
Timeline
Benefits Verification Specialist
CVS Health
06.2017 - Current
Pharmacy Technician
Rite Aid
04.2015 - 01.2017
AR Billing Specialist
McKesson Billing for Surgery
12.2011 - 07.2013
Liaisons Representative
Apria DME
06.2010 - 12.2012
Serra High School
No Degree - Microsoft Programs, Excel
Long Beach City College