Brittany Clay
Farmersville
Summary
Healthcare professional bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty. Knowledgeable in customer service practices, payment processing and medical billing. Collects and validates patient demographics, prepares medical charts, and conducts insurance verification. Detail-oriented team player comfortable working independently. Committed to achieving company objectives and providing excellent assistance to patients.
Overview
13
13
years of professional experience
Work History
Patient Benefits Specialist
US Oncology
McKinney
11.2021 - Current
- Ensures compliance with relevant laws governing employee benefits packages.
- May educate patients, staff and providers regarding prior authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance changes or trends.
- Coordinates with third-party vendors regarding reimbursements or disputes over denied claims and payments.
- Assists patients with questions regarding their eligibility status or benefit coverage.
- Responds promptly and accurately to inquiries from patients, healthcare providers, and insurance companies via phone or email.
- Manages daily workloads while meeting deadlines set by management.
- Resolves issues related to pre-authorization process with payers and other external entities.
- Obtains insurance authorization and pre-certification for all high dollar procedures and chemotherapy medications.
- Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.
- Responsible for obtaining insurance pre-authorization and or referral approval codes prior to each treatment.
- Updates insurance, financial responsibility and other data when changes or additions occur, and communicates to patient as appropriate. Ensures insurance and patient information obtained is complete and accurate, applying acquired knowledge of government and third party payor requirements.
- Maintains working knowledge of coordination of benefits as it relates to identifying possible claim issues prior to patient visit.
- Stays current on continuous insurance changes and laws, utilizing all resources available.
Reimbursement Specialist
Walgreens
Frisco
08.2017 - 04.2018
- Prevented delays and claim denials by correcting information prior to submission
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims
- Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results
- Employed clinical and billing codes expertise to correct billing inconsistencies
- Monitored outstanding invoices and performed collections duties
- Followed up on denied and unpaid claims to resolve problems and obtain payments
- Delivered timely information to insurance representatives to resolve common and complex issues
Certified Pharmacy Technician, Oncology
AmerisourceBergen
Frisco
01.2016 - 07.2017
- Completed paperwork, entering prescription and insurance or billing information into patient profiles
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient
- Reviewed and verified customer information and insurance provider information
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems and locating items
- Worked with computerized and automated systems for dispensing medications and editing new patient profiles
Retention Coordinator-CPhT
DaVita Rx
Coppell
12.2014 - 01.2016
- Resolved non-routine issues like third-party billing, computer system and customer service issues
- Answered incoming phone calls and addressed questions from customers and healthcare providers
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient
- Utilized knowledge of customer experience to create specialized plans for customer retention
- Utilized advanced skills in solving problems and making accurate decisions to implement strategies that brought about immediate results
- Adhered to appropriate legal scripting when required
- Collected customer feedback and made process changes to exceed customer satisfaction goals
- Recorded product or service failure complaints and notified appropriate departments
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues
- Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments
Lead Certified Pharmacy Technician
CVS Pharmacy
Frisco
03.2012 - 10.2014
- Answered incoming phone calls and addressed questions from customers and healthcare providers
- Reviewed and verified customer information and insurance provider information
- Communicated with prescribers to verify medication dosages, refill authorizations and patient information
- Counted, measured, and compounded medications following standard procedures
- Maintained proper drug storage procedures, registries, and records for controlled drugs
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient
Education
High School Diploma -
Allen High School
Allen, TX06.2010
Associate of Science - Nursing
Collin County Community College District
Plano, TXSkills
- Proficient in the use of end-user computer applications (Microsoft Office, Excel, Outlook), database and patient scheduling and other medical information systems
- Skilled at Multi-tasking, organizational skills and superb attention to detail
- Demonstrates high degree of professionalism and adaptability
- Comprehensive understanding of clinical office procedures, medical practice and oncology medical terminology
- Ability to work effectively with all levels of management and other colleagues
- Knowledgeable of current insurance
- Is able to adjust to multiple demands, shifting priorities and rapid change
- Knowledgeable of medical coding, specifically oncology and urology coding
- Has the ability to verbally communicate clearly and utilize the appropriate and correct terminology
- Capability to manage multiple tasks and prioritize workload to meet deadlines
- Keen Attention to Detail, Dependable, accountable, quick learner
Timeline
Patient Benefits Specialist
US Oncology
11.2021 - Current
Reimbursement Specialist
Walgreens
08.2017 - 04.2018
Certified Pharmacy Technician, Oncology
AmerisourceBergen
01.2016 - 07.2017
Retention Coordinator-CPhT
DaVita Rx
12.2014 - 01.2016
Lead Certified Pharmacy Technician
CVS Pharmacy
03.2012 - 10.2014
High School Diploma -
Allen High School
Associate of Science - Nursing
Collin County Community College District