Carlicia Thompson
Shaker Heights,OH
Summary
Qualified professional looking to join an organization where all of my skills and experience can be utilized to enhance the quality of your company. Friendly, goal oriented personality looking for an environment that values honesty, dedication and creativity, where I can grow and add value to your company.
Overview
18
18
years of professional experience
Work History
Reimbursement Specialist
ExactCare Pharmacy
Cleveland, Ohio
03.2024 - Current
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.
Accounts Receivable Clerk
Generations Behavioral Health
Cleveland, OH
01.2024 - 08.2024
- Improved cash flow by streamlining the invoicing process and implementing a more efficient payment tracking system.
- Reduced outstanding account balances through diligent follow-up on overdue invoices and negotiating payment arrangements with clients.
- Enhanced financial reporting accuracy by reconciling accounts receivable ledger with general ledger monthly.
- Collaborated with sales team to resolve billing discrepancies, resulting in improved customer relationships and increased client satisfaction.
- Maintained up-to-date customer contact information, enabling effective communication regarding account status and payment inquiries.
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
- Established strong working relationships with cross-functional teams to ensure seamless coordination during the account review process.
- Reduced errors in account reviews by implementing a thorough quality control process, consistently maintaining accuracy standards.
Pharmacy Billing Coordinator(Temporary-contract)
Centene
Remote
08.2023 - 01.2024
- Analyzed and summarized data to support and develop efficient workflow operations.
- Follow up on unpaid claims, outreach to providers and members for unpaid balances.
- Submitted pre-authorization paperwork electronically to insurance companies and providers.
- Coordinated activities and schedules of pharmacy staff to maximum efficiency and outcomes.
- Monitored pharmaceutical stock to determine inventory level, anticipating required medications and supplies as well as placing and expediting orders.
- Developed and implemented initiatives to maintain pharmacy's continual readiness.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Updated documentation, reports and spreadsheets with financial information.
Client Service Representative
Humana
Remote
10.2021 - 08.2023
- Communicate with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Provide consultations and answered inquiries from patients, healthcare professionals and physicians regarding drugs, potential side effects and specified use.
- Assist patients in minimizing medical expenses by recommending generic alternative prescription medications.
- Coordinate with insurance representatives to process claims and calculate correct co-pay information for patients.
- Communicate with prescribers to verify medication dosages, refill authorizations and patient information.
- Collect co-payments or full payments from customers.
- Perform various pharmacy operational activities with strong commitment to accuracy, efficiency and service quality.
- Resolve non-routine issues like third-party billing, computer system and customer service issues.
- Respond to customer requests, offering excellent support and tailored recommendations to address needs.
- Help a large volume of customers every day with positive attitude and focus on customer satisfaction.
Billing Specialist (Internship)
National Diagnostic Imaging
Cleveland, OH
11.2022 - 07.2023
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Generated and submitted invoices based upon established accounts receivable schedules and terms
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
- Handled account payments and provided information regarding outstanding balances.
- Code radiology case studies for MRI's, Ultrasounds, CT scans and Xrays through PACS systems.
- Collaborated with customers to resolve disputes.
Certified Pharmacy Technician
University Hospitals
10.2018 - 09.2021
- Performed sterile parenteral procedures using proper aseptic technique
- Worked in conjunction with automated dispensing technology to supply correct medications for individual patients, according to pharmacist and physician orders.
- Provided resolution or triage service response to telephone and digital messaging inquiries.
- Performed receiving, storage, and data entry of medications and materials received from suppliers.
- Operated pharmacy automation systems in accordance with department SOPs including, but not limited to Omnicell Medication Cabinets and Talyst Carousel drug storage system.
- Prepared and/or filled medication orders (oral, topical, etc.) under the supervision of a licensed pharmacist.
- Screen patient medication orders for accuracy, resolves questions in consultation with licensed pharmacist.
- Computer Utilization Properly operate EMR (Electronic Medical Record) for UH Care system; use pharmacy information system to run reports and access medication data; compile and send orders through CPOE.
- Communication and teamwork – Communicated with other caregivers and patients in an effective and positive manner.
- Assist with pharmacy caregiver and student training
Certified Pharmacy Technician
Cleveland Clinic Specialty Pharmacy
08.2020 - 08.2021
- Work alongside a disease management oncology team/ prior authorization team. Obtaining benefits investigation for insurance plans such as billing Medicare D, and Medicaid prescriptions to coordinate deliveries of specialty medication to patients.
- Maintains daily reports and email requests from all departments regarding patient information, prior authorization, billing and plan information changes.
- Work closely with pharmacist and medication software input to safely and accurately dispense medications in EMR Epic/Willow systems.
- Obtain prior authorizations and run test claims with third party billing while using databases/ software.
- Answering inbound calls and providing superior customer service to patients, drug companies, doctor offices, and case workers
- Verify patient data and billing information to discover and resolve erroneous bills due to system errors.
- Process incoming drug orders by checking deliveries against paperwork and updating data along with new order entries
- Prepared financial assistance programs for more affordable plans to patients.
Certified Pharmacy Technician
Institutional Pharmacy Solutions
04.2016 - 08.2018
- Unit dose bulk items for use in the Medstation.
- Review all drugs on Pyxis console for inventory.
- Assist with ordering meds.
- Pull medications from shelf and deliver to all units of the hospital.
- Refill all Pyxis machines.
- Run daily discrepancy reports and override reports.
- Reviewed and verified customer information and insurance provider information.
- Counted, measured, and compounded medications following standard procedures.
- Communicated directly with doctors offices via telephone, fax, and email.
Certified Pharmacy Technician
ExactCare Pharmacy
08.2013 - 12.2015
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Collected co-payments or full payments from customers.
- Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
Certified Pharmacy Technician
Walgreens
08.2006 - 03.2013
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Reviewed and verified customer information and insurance provider information.
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
- Communicated directly with doctors offices via telephone, fax and email.
- Collected co-payments or full payments from customers.
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
Education
Certification In Medical Billing And Coding - Medical Billing And Coding Program
Northern Career Institute
Eastlake, OH06.2023
Certification in Pharmacy Technician - Pharmacy Technology
Remington College
Cleveland, OH08.2006
High school diploma or GED - Computer And Information Sciences
Jane Addams Business Careers High School
Cleveland, OH06.2004
Skills
- Recordkeeping and Documentation
- Answering and Routing Calls
- Prescription Filling and Labeling
- Payment
- Prescription Pricing
- Inventory Management
- Prescription Order Verification
- Customer Service
- Data Entry
- Medical Insurance Claims Processing
- Pyxis
- Insurance Claim Processing Software
- HIPAA Compliance
- Microsoft Office/Excel/Outlook
- Bulk Medicine Prepacking
- Prescription Refill Fulfillment
- Extensive knowledge of ICD-10/ CPT/ HCPCS/ coding
- Medical Terminology 350 Certification/Dean Vaughn Certification
- OSHA/ HIPPA
- EPIC/ Willow/ Cerner
- MediSoft/ HITECH/ PACS
- Accounts Receivable
- Account Reconciliation
- Microsoft Excel
- Customer Service Support
- Claims Processing
Additional Information
- Certified Billing and Coding Specialist (CBCS)
- Certified Electronic Health Record Specialist (CEHRS)
- Certified Medical Administrative Assistant (CMAA)
- September 2007 to January 2024 Active State Board of Pharmacy Registered Technician PTCB Certification Pharmacy Technician License
Timeline
Reimbursement Specialist
ExactCare Pharmacy
03.2024 - Current
Accounts Receivable Clerk
Generations Behavioral Health
01.2024 - 08.2024
Pharmacy Billing Coordinator(Temporary-contract)
Centene
08.2023 - 01.2024
Billing Specialist (Internship)
National Diagnostic Imaging
11.2022 - 07.2023
Client Service Representative
Humana
10.2021 - 08.2023
Certified Pharmacy Technician
Cleveland Clinic Specialty Pharmacy
08.2020 - 08.2021
Certified Pharmacy Technician
University Hospitals
10.2018 - 09.2021
Certified Pharmacy Technician
Institutional Pharmacy Solutions
04.2016 - 08.2018
Certified Pharmacy Technician
ExactCare Pharmacy
08.2013 - 12.2015
Certified Pharmacy Technician
Walgreens
08.2006 - 03.2013
Certification In Medical Billing And Coding - Medical Billing And Coding Program
Northern Career Institute
Certification in Pharmacy Technician - Pharmacy Technology
Remington College
High school diploma or GED - Computer And Information Sciences
Jane Addams Business Careers High School