ANDREA PARDON
Santa Clarita,CA
Summary
Over 8 years providing exceptional customer service by communicating effectively verbally, in writing and have great social & relationship skills. Bilingual and computer proficiency with speed and accuracy in Microsoft Office software programs including Excel, Word, Outlook, & pharmacy billing platforms. Securely manage and maintains confidential sensitive reports, files & databases. Enjoy collaborating with a team, equally independent & productive working under minimal supervision. Enforce rules and regulations and adapt well to changes and applying new policies.
Overview
10
10
years of professional experience
Work History
OFFICE COORDINATOR
Valley Vascular Associates
10.2021 - Current
- Scheduled new patient consultations, obtaining information such as medical group, PPO's and health plans as well as general demographics.
- Greeted and logged in patients arriving at clinic
- Showed patients to examination rooms and prepared for physician
- Recorded patients' medical history, vital statistics and information such as test resulted in medical records
- Verified insurance of patients to determine eligibility.
- Conducted pre-authorizations and referrals to meet third-party insurer requirements
- Authorized drug refills and provided prescription information to pharmacies
- Changed dressings on wounds and amputations
- Performed catheter removals on patients adhering to doctor
- Performed general office duties, such as answering telephones, taking dictation and completing insurance forms
- Posted payments and collections on regular basis.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Oversaw daily Billing Department functions, including medical coding, charge entry, payment posting, and reimbursement management.
- Reviewed and validated accuracy of charges including dates of service, services provided, location and provider signature.
- Entered CPT codes and date of service into billing software for physician hospital cases.
- Conducted training for onboarding employees
LEAD PATIENT COORDINATOR
Diplomat Specialty Pharmacy
08.2013 - 09.2021
- Maintained frequent communication with colleagues, patients, doctor offices & outside partner facilities
- Maintained strict patient confidentiality to adhere to HIPAA regulations and avoid data compromises
- Created new customer profiles and updated changes such as demographics, allergies and new medications in computer systems
- Flagged potential drug interactions and allergies to prescribed medications for patients with different health conditions
- Handled patients complaints and conducted meetings for resolutions for improved communication
- Created and conducted training manuals for onboarding pharmacy trainees
- Proficient in pharmacy billing programs: Etreby, RX30
- Transmitted claims to insurance companies for payment
- Created excel reports for insurance companies as needed to be submitted quarterly
- Conducted verification of eligibility for patients insurance plans
- Knowledgeable on recently developed FDA approved specialty medications as several of these medications are considered limited distribution (limited pharmacies are on panel to dispense per contract)
- Researched pharmacies based upon contracts with insurance companies to verify mandate policy for patients prescriptions
- Prepared prescription transfers to other pharmacies
- Performed routine research for new doctors offices to obtain valid prescription documentation as needed
- Conducted the accuracy check and corrections for prescriptions that may have any errors or otherwise incomplete per pharmacy law to be completed for dispensing
- Inputted missing data into pharmacy billing system (RX30) to conduct processing for prescriptions
- Conducted overview to verify all prescription types are complete prior to dispensing such as; prior authorization (approval by insurance), copay assistance (financial assistance offered by non profit organizations)
- Organized repeat prescriptions (refills) for proper processing
Education
BUSINESS ADMINISTRATION AND MANAGEMENT
College Of The Canyons
Santa Clarita, CASkills
- Insurance Verification
- Communication
- Workflow Optimization
- Resolving customer issues
- Quality assurance and control
- CPT Coding
- Patient Eligibility Requirements
Timeline
OFFICE COORDINATOR
Valley Vascular Associates
10.2021 - Current
LEAD PATIENT COORDINATOR
Diplomat Specialty Pharmacy
08.2013 - 09.2021
BUSINESS ADMINISTRATION AND MANAGEMENT
College Of The Canyons