Asante Wilson
Milwaukie,Oregon
Summary
Results-oriented Reimbursement Specialist with extensive experience at Genentech Access Solutions, specializing in policy analysis and exceptional client service. Achievements include optimizing compliance with HIPAA regulations and improving reimbursement processes through effective eligibility verification, significantly enhancing coverage access. Committed to ongoing professional development and adherence to industry standards.
Overview
5
5
years of professional experience
Work History
Reimbursement Specialist
Genentech Access Solutions
Portland, Oregon
04.2020 - Current
- Monitored changes in industry standards related to reimbursements and updated internal policies accordingly.
- Investigated complex cases involving multiple providers or incorrect coding issues.
- Reviewed and processed reimbursement requests in accordance with company policies and procedures.
- Drafted documents based on payer guidelines and submitted to necessary parties.
- Enforced compliance with organizational policies and federal requirements regarding confidentiality.
- Identified opportunities for coverage access to address reimbursement barriers.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
- Determined medical necessity, using individual insurance carrier regulations.
- Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability.
- Maintained confidentiality and integrity of patient data.
Skills
- Eligibility verification
- Policy analysis
- Denial management
- HIPAA compliance
- Insurance verification
- Data recording
- Administrative writing
- Client service
- Policy evaluation
- Flexible availability
- Appeals handling
- Multi-tasking
- Completing goal-oriented tasks within a team
Projects and Trainings
- Preceptor for incoming RS
- Care Team SME
- Staff Pooler for Optha BR
References
References available upon request.
Timeline
Reimbursement Specialist
Genentech Access Solutions
04.2020 - Current
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