Ariana Williams
Oxford,NC
Summary
Dynamic Patient Access Representative with extensive experience at Biologics by McKesson, excelling in claims processing and prior authorization. Proven ability to deliver exceptional customer service while maintaining HIPAA compliance. Skilled in navigating complex insurance systems, ensuring patients receive timely access to necessary therapies. Proficient in Microsoft Office and adept at multi-tasking in fast-paced environments.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Patient Access Representative
Biologics by McKesson
Cary, USA
05.2024 - Current
- Verifying insurance coverage
- Handling prior authorization
- Inbound/Outbound calls
- Processing Insurance claims for medication approvals
- Adhered to HIPAA policies and protocols
Patient Access Representative
Remx
Cary, USA
08.2023 - 05.2024
- Used insurance websites and phone contact to open Commercial insurance, Medicare, and Medicaid claims on behalf of clients.
- Worked with support staff to guide clients through their case and provide an exceptional level of customer service.
- Explained explanation of benefits to members.
Reimbursement Case Manager
Trial Card
Morrisville, USA
01.2023 - 08.2023
- Served as an expert on reimbursement issues completing over 60 inbound and outbound calls daily.
- Completed medical and/or pharmacy benefit investigations.
- Identified and requested submission of required documentation for payer/plan.
- Maintained a high level of ethical conduct regarding confidentiality and privacy.
- Reviewed for prior authorization, step edit identification, and appeals according to program standard operating procedures.
- Maintained knowledge and understanding of the different types of major payers including private, commercial, and government insurances.
- Determined coverage availability and coordinated the final aspects of health care services to ensure patients have access to prescribed therapy.
Medical Assistant
Vance Family Medicine
Henderson, USA
08.2022 - 02.2023
- Answered incoming calls from patients calling to schedule appointments.
- Updated and maintained patients' records.
- Provided information to patients about referrals to other doctor's offices, specialists, and surgeons.
- Helped with infection control by sterilizing and disinfecting instruments.
- Assisted doctors in managing medical emergencies when necessary.
- Resolved patient complaints and explained why certain services aren't covered.
- Researched denied claims, conducted coding reviews of medical records, and supported documentation against denied claims.
- Processed claims and performed completion of claims to payers.
Education
GED -
Vance-Granville Community College
Henderson, North Carolina, NC02-2010
Skills
- Excellent Customer Service
- Microsoft Office Proficiency
- Multi-tasking Abilities
- Type 50 WPM
- Claims
- Prior authorization
- HIPAA compliance
Certification
- Data Entry & 10-Key Proficiency
- Microsoft Office Proficiency
- Medical Assistant
Languages
English
Timeline
Patient Access Representative
Biologics by McKesson
05.2024 - Current
Patient Access Representative
Remx
08.2023 - 05.2024
Reimbursement Case Manager
Trial Card
01.2023 - 08.2023
Medical Assistant
Vance Family Medicine
08.2022 - 02.2023
GED -
Vance-Granville Community College