ANDREW CONTRERAS

• Oversaw regional operations, ensuring compliance with company standards and policies.
• Developed and monitored key performance indicators to drive regional success and accountability.
• Implemented process improvements that reduced operational delays across multiple locations.
• Led training programs for new supervisors, enhancing team performance and operational efficiency.
• Facilitated cross-functional communication between departments to streamline workflows and resolve issues.
• Mentored junior supervisors, fostering professional growth and enhancing leadership capabilities within the team.
• Oversaw the recruitment process to ensure the hiring of top talent in alignment with company objectives.
• Enhanced employee productivity through regular training sessions and constructive feedback.
• Directed training, promotions, and employee motivation to minimize turnover and maximize productivity.
• • Monitor Insurance Admins via daily communications to the field
• • Review daily reports looking for corrections
• • Audit Insurance Admin work daily
• • Consult with sales VP and field reps to better process accounts
• • Approve time and PTO request
• • Work with other supervisors daily planning work strategy for Insurance Admins
• • Coach Insurance Admins and field reps as needed
• • Prep and lead team meetings as well as departmental meetings
• • Provide training when new payer processes have been identified
• • Promote Compliance adherence
• • Troubleshoot accounts with Insurance Admins and field reps

Verify medical benefits for Medicaid, commercial payers, Work comp and Auto claims

Submit authorizations as directed by payer

• Followed up on submitted authorizations every 3 days to ensure timely processing

• Completed priority orders within 24 hours to meet urgent client needs

• Communicate with territory managers concerning order progress

• Managed daily workload efficiently within appropriate time frame

• Skilled in using portals to obtain benefits and/or submit authorizations

• Attend training and keep current with online modules

• I use a professional communication when emailing or speaking with TM's, ATM and call co-workers

Oversaw daily operations to ensure smooth workflow among team members.• Prioritized and distributed case load for over 100 individuals across multiple dates• Added Payer information for system processing• Managed Payer set up in processing system• Identified & trended Payer issues• Performed quality audits for new & existing employees• Trained new and existing reimbursement representatives in classroomGenerated daily reports for production and case management, presenting findings in management meetingsnt meetings• Handle escalated calls from patients or physicians' offices• AudConducted audits of cases and phone calls to ensure adherence to procedures

• Led reimbursement process improvements to enhance efficiency and accuracy in claims submission.
• Mentored team members on regulatory compliance and best practices for reimbursement procedures.
• Developed training materials to streamline onboarding and knowledge transfer for new staff.

• Verified medical benefits through Medicare, Medicaid & commercial payers

• Verified Pharmacy benefits through various Pharmacy Benefit Managers (PBM) or vendors

• Identified and offered patients to copay assistance program

• Identified and offered patients to copay assistance program

• Provided patient's with medical & pharmacy benefits by drug

• Conducted regional quality audits on cases to ensure accuracy of reported benefits and compliance

• Conducted quality audits by region on cases to ensure accuracy of reported benefits

• Managed a team of 8 to meet daily goals

• Supported inbound calls from providers and patients

• Conducted side by side training for new employees to secure necessary reimbursements

• Processed and dispensed medications accurately, ensuring adherence to safety protocols and regulatory standards.
• Collaborated with pharmacists to manage inventory levels, optimizing stock to meet patient needs efficiently.
• Assisted in training new pharmacy technicians, enhancing team knowledge and operational performance.
• Implemented medication management practices that improved workflow efficiency and reduced errors during dispensing processes.

• Resolved customer inquiries and issues through effective communication and problem-solving techniques.
• Maintained accurate records of customer interactions using CRM software to improve service efficiency.
• Guided customers in navigating products and services, enhancing overall user experience.
• Managed high-volume calls while maintaining composure and professionalism under pressure.
• Collaborated with team members to streamline processes, improving response times and service quality.

• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Stocked, labeled, and inventoried medication to keep accurate records.
• Completed paperwork, entering prescription and insurance or billing information into patient profiles.
• Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
• Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.