Casey Sponhouse
Chandler,AZ
Summary
Looking to expand in the world of pharmacy to provide outstanding service in the healthcare industry.
Overview
1
1
year of professional experience
1
1
Certification
Work History
Care Coordinator III
House Rx
12.2024 - Current
- Providing training to all new team members
- Assisting Team and Pharmacists with resubmissions, reconsiderations and appeals
- Outbound communication with third party payer insurance plans to ensure maximum approval (This includes challenging clinician reviewers to overturn denials or re-review additional information)
- High performer with prior authorization submissions in the 100s
- Knowledge in many specialty disease states (Rheumatology, Neurology, Dermatology, ETC)
- Outbound calls to third party payers, external pharmacies, and patients.
- Inbound calls from patients, clinic staff, third party payers.
- Resolving barriers for patients regarding high touch specialty medications
- Experience with adjudicating pharmacy claims and navigating multiple EHR systems
National Liaison
Shields Health Solutions
06.2021
- Coordinate deliveries between liaisons and the pharmacy
- Coverage of call outs and planned PTO on liaison clinics
- Working directly with clinic staff and patients to provide outstanding care
- Completing prior authorization on specialty medications
- Removing barriers on financial burden to patients
Patient Support Lead
Shields Health Solutions
12.2020
- Collaborating with health systems and various teams within Shields to create positive outcomes.
- Providing training, coaching, and team engagement.
- Auditing team members to ensure compliance and efficiency.
- Assisting with PTO and Callouts for necessary coverage
Patient Support Advocate
Shields Health Solutions
11.2018
- Provide high touch patient care by obtaining medications that were once blocked by insurance companies.
- Working side by side with providers and insurance companies to meet approvals necessary for prior authorizations.
- Researching a variety of funding sources for patients that are met with high dollar co-pays.
- Ability to work through different pharmacy dispensing systems to adjudicate claims, refill medications and increase adherence in patients.
(SME) Pharmacy Technician
Optum Specialty Pharmacy (Select)
09.2018
- Select point of contact for 3 Multiple Sclerosis offices
- Provide a high level touch service to clients and patients
- Complete all prior authorizations and financial assistance on behalf of providers.
- (SME) Subject Matter Expert in Multiple Sclerosis to assist other team members with disease therapy questions.
Lead Pharmacy Technician
GenRx Pharmacy
12.2015
- Make outbound calls to patients regarding medication refills
- Assist other technicians in workflow
- Take inbound calls from patients regarding any concerns
- Data Entry Third party processing
Pharmacy Technician
Banner Family Pharmacy Gateway Medical Center
08.2013
- Ability to communicate with nurses and doctors within the hospital setting.
- Proactive in processing prior authorizations and manufacture coupons to lower co pays for patients.
- Effectively comparing prices with wholesaler to keep the best priced medications in stock.
- Checking and maintaining inventory within the needed guidelines
Pharmacy Technician
Walgreens Drug Store
06.2008
- Creating customer trust by instilling HIPPA practices within the pharmacy
- Efficiently fill prescriptions correctly and quickly.
- Ability to work with insurance plans to process claims appropriately
- Section assigned to in pharmacy is well-organized, clean and maintained during expiration checks.
- Proficient in multi-tasking when needed to. (ex. Incoming/outgoing calls while filling prescriptions, or filing prescriptions to appropriate name bin)
Sales Associate
Walgreens Drug Store
06.2008
- Assisting customer with needs (help in photo, cosmetics, etc.)
- Keeping a balanced register during and at the end of shifts
- Keeping a clean work environment for customers and team members
Education
High school Diploma - undefined
Mountain Pointe High School
05.2008
Skills
- Case management
- Documentation
- Patient education
- Organizational skills
- Patient advocacy
- Medical terminology understanding
- Scheduling
- Claims processing
- Quality assurance
- Medical terminology
- Insurance practices
- Health literacy
- Problem-solving
- Time management
- Multitasking and organization
- Clear communication
- Team collaboration
- HIPAA compliance
- Verbal and written communication
- Data entry
- Client relationship management
- Empathy and compassion
Certification
- Pharmacy Technician PTCB
- Arizona State Board of Pharmacy
- T037752 10088176
Timeline
Care Coordinator III
House Rx
12.2024 - Current
National Liaison
Shields Health Solutions
06.2021
Patient Support Lead
Shields Health Solutions
12.2020
Patient Support Advocate
Shields Health Solutions
11.2018
(SME) Pharmacy Technician
Optum Specialty Pharmacy (Select)
09.2018
Lead Pharmacy Technician
GenRx Pharmacy
12.2015
Pharmacy Technician
Banner Family Pharmacy Gateway Medical Center
08.2013
Pharmacy Technician
Walgreens Drug Store
06.2008
Sales Associate
Walgreens Drug Store
06.2008
High school Diploma - undefined
Mountain Pointe High School