BRITNEE TANNER
Port Jervis,NY
Summary
Dedicated Healthcare Representative with a strong foundation in computer systems, software applications, and medical terminology, complemented by a commitment to delivering exceptional customer service. Proven ability to quickly master new technologies and adapt to dynamic environments, showcasing flexibility and effective teamwork. Upholds the highest standards of confidentiality and integrity in managing sensitive information, ensuring compliance with established policies and procedures. Recognized for meticulous attention to detail, superior organizational skills, and efficient time management capabilities.
Overview
10
10
years of professional experience
Work History
Coverage Determinations and Appeals Representative Medicare Part D
CVS Caremark
04.2024 - Current
- Researched reports, maintaining complete, timely and accurate documentation of Coverage Determination/Appeal requests and escalating issues to the Coverage Determination/Appeal pharmacists or management staff as needed.
- Reviewed each document with accuracy and place the case in the proper queues.
- Researched and conducted outreach via phone to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close cases
- Worked closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations
- Utilizing multiple software systems to complete Medicare Prior Authorization case reviews
- Managed over 50 calls per day
- Improved customer satisfaction by efficiently handling and resolving appeals in a timely manner.
- Conducted comprehensive reviews of Coverage Determination and Appeal requests to ensure compliance with Medicare Part D guidelines.
Patient Access Representative
Garnet Health
01.2018 - 03.2023
- Welcomed and greeted patients and visitors, in person or on the telephone, answering or referring inquiries.
- Assisted patients with appointment scheduling, pre-service registration, insurance verification, co-pay collection, physician referrals, initial screening of patient's signs/symptoms, class scheduling and any other questions or concerns.
- Kept patient's appointments on schedule by notifying the provider of the patient's arrival, reviewing service delivery compared to schedule and reminding the provider of service delays
- Confirmed pre-admission information and obtained signatures on legal consents and insurance forms.
- Oversaw and prioritized bed availability needed to ensure prompt and appropriate bed assignments of patients.
- Admitted emergency room and maternity patients by receiving medical orders from physicians and confirming privileges with nursing supervisors.
Medical Transportation Coordinator
Senior Care EMS
08.2015 - 01.2018
- Answered incoming emergency/non-emergency calls and obtained the necessary demographic information required for reimbursement of all services.
- Scheduled patient transport services to ensure timely arrivals for medical appointments.
- Managed and resolved patient complaints.
- Collaborated with various Nursing homes, clinics, and hospitals on providing different levels of transportation for patients.
- Completed various tasks such as faxes and various requests from hospitals and clinics.
- Maintained accurate records of transportation services for billing and auditing purposes.
- Resolved patient inquiries and complaints related to transportation services effectively.
- Coordinated driver dispatch to accomplish daily delivery requirements.
Education
High School Diploma - Healthcare Studies, Health Information Management
Finger Lakes Community College
12.2025
Emergency Medical Technician Certification -
Emergency Care Program
Bronx, NY09.2014
High School - Regents Diploma
Washington Irving High School
New York, NY06.2007
Skills
- Report management
- Proficient in following directions
- Strong prioritization of assignments
- Team development
- Proficient in interpreting diverse work instructions
- Proficient in computer applications
- Spreadsheet management
- Knowledge of NYS Medicaid and Medicare
- Proficient in Epic Systems
- Management of Rx claims
- Medical HOK systems expertise
- Skilled in emergency net operations
- Proficient in Microsoft Office
- Task scheduling
- Excel data analysis skills
- Visual communication skills
- Proficient in Google Docs
Timeline
Coverage Determinations and Appeals Representative Medicare Part D
CVS Caremark
04.2024 - Current
Patient Access Representative
Garnet Health
01.2018 - 03.2023
Medical Transportation Coordinator
Senior Care EMS
08.2015 - 01.2018
High School - Regents Diploma
Washington Irving High School
High School Diploma - Healthcare Studies, Health Information Management
Finger Lakes Community College
Emergency Medical Technician Certification -
Emergency Care Program