Open To Work
Arica Lewis
Lewisville,ID
Summary
Experienced healthcare and pharma leader with 20+ years of expertise in patient access, reimbursement strategies, and specialty distribution. Proven ability to educate healthcare providers on coverage, prior authorization, and appeals processes while driving operational excellence and compliance. I am skilled in payer trend analysis, strategic territory planning, and fostering strong relationships with HCPs and health system stakeholders.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Quality Assurance Supervisor, Customer Service Man
Cardinal Health
04.2023 - Current
- Serve as the primary liaison between healthcare providers, patients, and payers to ensure timely and accurate reimbursement for specialty therapies.
- Educate and support providers on reimbursement processes, prior authorizations, benefits investigations, and appeals to optimize patient access.
- Analyze payer policies and identify potential barriers; develop strategies to overcome coverage and reimbursement challenges.
- Deliver training and guidance to office staff on billing, coding, and documentation requirements to ensure compliance and efficiency.
- Maintain in-depth knowledge of insurance plans, government programs, and manufacturer assistance programs to provide accurate solutions.
- Build and maintain strong relationships with healthcare professionals, payers, and internal stakeholders to drive positive outcomes.
- Monitor reimbursement trends and provide actionable insights to improve patient access and program performance.
Supervisor, Access and Patient Support
Cardinal Health
04.2022 - 04.2023
- Supervised patient support and reimbursement teams responsible for enrollment, copay assistance, and benefit investigations for oncology product under both pharmacy and medical benefit coverage..
- Oversaw benefit investigations for both pharmacy and medical coverage, resolving complex payer issues and prior authorization challenges.
- Managed staffing schedules and resource allocation to meet client contractual requirements and adhere to company policies and SOPs.
- Delivered coaching and professional development to team members, improving performance and compliance with reimbursement processes.
- Represented the organization in quarterly client business reviews, addressing operational needs and identifying process improvement opportunities.
- Enhanced quality and accuracy of reimbursement support through call monitoring and case audits, driving continuous improvement in patient access outcomes.
Quality Assurance Supervisor, Customer Service
Cardinal Health
09.2019 - 04.2022
- Supervised patient support and reimbursement teams responsible for enrollment, copay assistance, and benefit investigations for neurology product under both pharmacy and medical benefit coverage.
- Managed staffing schedules to ensure compliance with client contracts, company policies, and standard operating procedures.
- Delivered coaching and professional development to team members, improving performance and adherence to reimbursement processes.
- Represented the organization in quarterly client business review meetings, addressing operational needs and identifying process improvement opportunities.
- Enhanced employee knowledge and service quality through call monitoring and case audits, driving continuous improvement in patient access outcomes
Supervisor, Access and Patient Support
Cardinal Health
10.2016 - 09.2019
- Supervised patient support and reimbursement teams responsible for enrollment, copay assistance, and benefit investigations for neurology medications under both pharmacy and medical benefit coverage.
- Managed staffing schedules to ensure compliance with client contracts, company policies, and standard operating procedures.
- Delivered coaching and professional development to team members, improving performance and adherence to reimbursement processes.
- Represented the organization in quarterly client business review meetings, addressing operational needs and identifying process improvement opportunities.
- Enhanced employee knowledge and service quality through call monitoring and case audits, driving continuous improvement in patient access outcomes.
Lead Coordinator, Individualized Care
Cardinal Health
06.2014 - 10.2016
- Exceeded workflow requirements by monitoring daily activities and managing shared folders to ensure operational efficiency.
- Handled inbound calls as needed, assessing patient needs and providing appropriate solutions using approved communication guidelines.
- Recognized as a team leader and assigned special projects to improve program performance and operational outcomes.
- Assisted team members with program-related inquiries, ensuring accuracy and compliance with established processes.
- Maintained comprehensive knowledge of daily operations to support seamless program execution.
- Conducted quality reviews and audits to ensure adherence to program standards and identify areas for improvement.
- Resolved escalated patient issues promptly, ensuring positive outcomes and patient satisfaction.
- Utilized multiple systems to maximize efficiency and monitor workflow for continuous improvement.
Sr. Coordinator, Individualized Care
Cardinal Health
06.2012 - 06.2014
- Contacted insurance companies to obtain and accurately enter benefit information, ensuring efficient insurance processing and minimizing claim rejections.
- Researched and resolved prescription processing rejections to meet patient standards and ensure timely medication delivery.
- Collaborated closely with the Pharmacy department to guarantee accurate and timely order receipt and processing.
- Followed up on benefit investigation rejections, including prior authorizations, appeals, and related coverage issues.
- Documented all actions clearly and concisely in patient records to maintain transparency and facilitate team communication.
Resolution Specialist
Medco Health Solutions
09.2007 - 04.2012
- Ensured all patient inquiries were handled accurately, courteously, and efficiently, providing clear guidance on reimbursement and access processes.
- Exercised independent judgment to resolve complex patient access challenges, offering creative solutions to minimize delays in therapy initiation.
- Delivered compassionate, professional communication to patients regarding insurance coverage, prior authorizations, copay assistance, and appeals.
- Provided proactive alternatives and resources, including manufacturer support programs and financial assistance options, to overcome payer barriers.
- Maintained a strong understanding of insurance benefits and patient assistance programs to educate and empower patients throughout the reimbursement process.
- Built trust and rapport with patients by offering personalized support and ensuring timely resolution of access issues.
Service Representative
Medco Health Solutions
12.2005 - 10.2006
- Delivered exceptional customer service by addressing inquiries and resolving issues efficiently.
- Managed account updates, ensuring accuracy in customer records and information systems.
- Collaborated with cross-functional teams to streamline communication processes and enhance service delivery.
- Trained new staff on company policies and procedures to promote consistency in service quality.
- Maintained productivity and quality standards at all times.
- Maintained comprehensive knowledge of company products and services, ensuring accurate information was relayed to customers at all times.
Education
No Degree - Biology
Prairie View A&M University
Prairie View, TXSkills
- Revenue cycle management
- Claims processing
- Regulatory compliance
- Data analysis
- Financial reporting
- Problem solving
- Communication skills
- Team leadership
Accomplishments
- Supervised two teams simultaneously with a total of 23 staff members.
- Used Microsoft Excel to develop team tracking spreadsheets and scorecards.
Certification
- Certified ISO Internal Auditor - Cardinal/Sonexus Health Specialty Pharmacy
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
RemoteHybridSalary Range
$95000/yr - $200000/yrTimeline
Quality Assurance Supervisor, Customer Service Man
Cardinal Health
04.2023 - Current
Supervisor, Access and Patient Support
Cardinal Health
04.2022 - 04.2023
Quality Assurance Supervisor, Customer Service
Cardinal Health
09.2019 - 04.2022
Supervisor, Access and Patient Support
Cardinal Health
10.2016 - 09.2019
Lead Coordinator, Individualized Care
Cardinal Health
06.2014 - 10.2016
Sr. Coordinator, Individualized Care
Cardinal Health
06.2012 - 06.2014
Resolution Specialist
Medco Health Solutions
09.2007 - 04.2012
Service Representative
Medco Health Solutions
12.2005 - 10.2006
No Degree - Biology
Prairie View A&M University