Ashley R. Lemme

• Lead weekly team meetings with clinicians to identify and resolve patient concerns and workflow issues proactively
• Oversee patient onboarding and intake process into Brightree ensuring timely completion and turnover of patient cases.
• Train staff on best practices for engaging with patients and addressing their needs effectively
• Follow up on claim denials
• Enhance office productivity by identifying patient and provider needs, clarifying information, and bringing swift resolution to issues
• Utilize strong knowledge of basic medical terminology related to services and procedures
• Maximize reimbursement by verifying insurance coverage, receiving prior authorization, and relaying estimated out-of-pocket cost to patients
• Perform accurate entry of patient information into Brightree, ensuring diagnoses received are valid and billable
• Perform case audits prior to device delivery to ensure all documentation for medical necessity has been obtained, scripts are up to date, and authorizations are current
• Develop and maintain effective working relationships with patients, doctor's office staff, and clients via courteous, professional telephone, email, and in person communication
• Address patient billing concerns and collect payments
• Place and ship patient product orders, ensuring timely processing.

• Acted as a liaison between physicians, nursing staff, and other departments.
• Collected outside CT scans and pathology slides, recorded arrival times, and filled out appropriate requests to be read by NIH personnel.
• Communicated with various clinical administrative support offices/clinics/diagnostic centers concerning the scheduling of patient appointments, new and existing work scopes, and clinical protocols (Dexa scan, x-ray, etc.)
• Consulted with patients to schedule medical appointments and provided appointment information

to patients, including medical materials required, dates and times, clinic information, hospital maps, travel, and hotel information

• Developed and maintained effective working relationships with patients, doctor's office staff, and clients via courteous, professional telephone, email, and in person communication
• Consulted with patients to schedule medical appointments and provided appointment information to patients, including medical materials required, dates and times, clinic information, hospital maps, travel, and hotel information
• Arranged patient and caregiver travel including lodging, meals, and direct bill requests
• Updated and maintained calendar events
• Maintained roster of all patients and tracked their appointments
• Maintained patient database, patient education folders and status board for clinic patients
• Obtained up-to-date patient records and other pertinent information prior to appointments or admission
• Delivered slides/blocks to pathology for review
• Labeled and filed patient medical records (internal and external)
• Prepared patient protocol calendars and diaries for patients returning to clinic on protocol

• Enhanced office productivity by identifying patient and provider needs, clarifying information, and brought swift resolution to issues
• Utilized strong knowledge of basic medical terminology related to services and procedures
• Maximized reimbursement by verifying insurance coverage, receiving prior authorization, and relaying estimated out-of-pocket cost to patients
• Performed accurate entry of patient information into Brightree, ensuring diagnoses received are valid and billable
• Developed and maintained effective working relationships with patients, doctor's office staff, and clients via courteous, professional telephone, email, and in person communication
• Collected patient payments
• Placed and shipped patient product orders, ensuring timely processing.

• Served as a resource for Health Care Providers and patients using regional reimbursement, distribution, and payer policy expertise
• Provided solutions for complex patient access situations, working closely with the PAA team to appropriately escalate/resolve issues
• Performed intake of cases and captured all relevant information within Access 360 Case Management system
• Answered inbound calls, identifying patient and provider needs, clarified information, and brought resolution to issues
• Performed in-depth research into patient's insurance, prior authorization and appeal requests on behalf of providers
• Provided guidance to physician office staff and patients on how to complete and submit all necessary program applications in timely manner for purpose of accessing specialty medications.

• Collected and reviewed insurance benefit information, capturing patient data in Salesforce and Theracall
• Maximized efficiency by creating and implementing use of a benefit investigation template
• Increased team productivity and efficiency by creating spreadsheets to track case completion and assigning cases daily for completion
• Performed benefit investigations of major medical benefits to confirm drug coverage and relayed information to client case managers for the purpose of enrolling patient in copay program to help offset cost of specialty medications
• Assessed and enrolled patients into commercial copay program per criteria provided by client
• Accelerated the onboarding process by creating a training guide for new employees
• Reviewed claims and EOBs before transferring to claims department for processing.

• Collected and reviewed all patient insurance benefit information
• Increased productivity by running reports to determine caseload at the beginning of the day, midday, and prior to end of shift and would assign cases when the TC was out of office
• Assisted physician office staff and patients with prior authorization forms and supporting documentation to payers as well as followed up on appeal status
• Performed investigation of pharmacy benefits to confirm drug coverage as well as the specialty pharmacy that can dispense, completing 93% of all BI cases within 3 days
• Assisted colleagues to complete past due cases
• Performed online claim tests; investigated and brought resolution to insurance rejections.