Angela Benjamin
Davenport,FL
Summary
Organizationally driven healthcare professional with over 10 years of experience specializing in pharmacy care, medical authorizations, claims and client services. Known for excellence in client and customer satisfaction, as well as expertise in healthcare administration, with a focus on enhancing patient care and operational efficiency. Skilled in handling complex cases, managing insurance authorizations, and supporting interdisciplinary healthcare teams.
Overview
15
15
years of professional experience
Work History
Sr. Pharmacy Care Technician - Gastro SME & Onco
United Healthcare Group/OptumRx
06.2018 - Current
- Coordinated treatment plans with clients, patients, and healthcare providers to improve patient well-being.
- Successfully managed a portfolio generating over $2M in annual revenue, with a 1,500+ script fill rate.
- Accessed and reviewed EMR data, clinical notes, and lab results for prior authorization processes.
- Supported initiatives to enhance internal processes through active participation in company feedback programs.
- Troubleshooting claim rejections, contacting PBM's to resolve payment issues
- Verify/Obtain authorizations and eligibility utilizing payor web sites, client eligibility systems or via phone with insurance carrier/providers
Pre-Access Infusion Medical Benefits & Auth
AdventHealth Orlando
03.2022 - 03.2023
- Evaluated chemotherapy treatment orders, verifying insurance benefits and medical necessity in alignment with CMS standards.
- Secured pre-authorizations within required timeframes, ensuring patient access to timely treatments.
- Reviewed clinical data to confirm compliance with insurance and NCCN guidelines.
- Reviewed and evaluated hospital medical record documentation to assign, sequence, edit, and/or validate the appropriate ICD-10-CM and ICD-10- PCS codes
- Reviewed physician orders and insurance claims to verify accurate assignment of HCPCS codes and J-codes, ensuring correct and timely claim submission
ERAP Case Management Eligibility Specialist
Tetra Tech (Temporary Position)
Orlando, USA
10.2021 - 11.2021
- Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
- Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
Client Services & Biogen Reimbursement Specialist
McKesson
Orlando, USA
12.2012 - 05.2018
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.
LOA Case Specialist
AON Hewitt
Orlando, USA
02.2011 - 11.2012
- Analyzed and coordinated FMLA cases, ensuring compliance with state and federal regulations.
- Maintained accurate records and managed workflow processes to support client relationships.
- Maintained strict confidentiality of sensitive information, adhering to legal regulations and company policies.
- Participated in ongoing professional development opportunities to stay current on industry trends and best practices in case management.
- Exceeded performance expectations consistently by meeting deadlines while maintaining high-quality work standards.
Education
High School Diploma -
Penn Foster Career School
Scranton, PA03.2022
Skills
- Healthcare software
- Laboratory procedures
- Healthcare ethics
- Medical and pharmacy prior authorizations
- Claims
- CPT
- Billing
- Patient care
- HIPAA compliance
- ICD-10
- HCPCS
- EMR systems
- Microsoft Word
- Microsoft Excel
- Data Entry
- Third-party verification
- Program-specific software for case management
- Salesforce
- Epic
- SureScripts
- Availity
- Communication
- Customer service
- Teamwork
- Critical thinking
- Adaptability
- Time management
- Attention to detail
Timeline
Pre-Access Infusion Medical Benefits & Auth
AdventHealth Orlando
03.2022 - 03.2023
ERAP Case Management Eligibility Specialist
Tetra Tech (Temporary Position)
10.2021 - 11.2021
Sr. Pharmacy Care Technician - Gastro SME & Onco
United Healthcare Group/OptumRx
06.2018 - Current
Client Services & Biogen Reimbursement Specialist
McKesson
12.2012 - 05.2018
LOA Case Specialist
AON Hewitt
02.2011 - 11.2012
High School Diploma -
Penn Foster Career School