Catherine (Cathy) Chamness
Apache Junction,AZ
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level claims position. Ready to help team achieve company goals. I have over 20 years of experience in various aspects of the healthcare industry that I would like to offer and utilize.
Overview
25
25
years of professional experience
Work History
Patient Care Coordinator
Wellcare Health Plans
06.2019 - Current
- Employment, Coordinate incoming calls from members via call center
- Acted as main point of contact for patients, doctors, and hospital staff in regard to patients needs
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Responded to inquiries by directing calls to appropriate personnel.
- Educated members in regard to care management programs
- Assist with getting members to their Care Managers or correct department..
Case Manager
RemX/Mckesson
09.2018 - 02.2019
- Processed patient assistance applications for the cancer drug Keytruda
- Performed benefits investigations for patients
- Collaborated with an interdisciplinary team to determine timely delivery of services.
- Verified by telephone or internet eligibility and benefits for third-party payer insurance from information provided on patient registration form.
PRIOR AUTHORIZATION ASSOCIATE
Wipro Infocrossing
09.2014 - 06.2018
- Completes duties in an accurate manner with appropriate application of criteria or review directives evident in review outcome or educational information
- Performed call center duties remotely when inclement weather or other need arose
- Interacted with providers and other medical professionals regarding, policies, procedures and regulations
- Familiar with CPT and ICD-10 codes
- Offered supervisor and manager with immediate feedback on issues affecting workflow, reimbursement and customer service.
PHARMACY TECHNICIAN
Walmart Pharmacy
09.2011 - 07.2014
- Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Resolved third-party billing, computer system and customer service issues.
DEALER LICENSING TECHNICIAN
Missouri Department Of Revenue
10.2003 - 08.2004
- Researched and maintained office records
- Collected and input data for departmental research
- Supported staff on special assignments and ad hoc projects.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
TAXATION CLERK
Missouri Department of Revenue
10.2003 - 08.2004
- Provided quality clerical support through data entry, document management and email correspondence, processing state tax returns
- Corrected and filed rejected applications according to guidelines while processing vehicle title applications
- Edited and proofread documents for accuracy and completeness
- Compiled and analyzed data to produce reports.
MEDICARE CLAIMS PROCESSOR
National Heritage Insurance Company
10.1998 - 10.2000
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Made payment decisions according to Medicare guidelines
- Trained in ICD-9 and CPT coding
- Required security clearance.
- Checked documentation for accuracy and validity on updated systems.
- Maintained confidentiality of patient finances, records, and health statuses.
- Verified client information by analyzing existing evidence on file.
Education
Bachelor of Science - Business Administration
Columbia College
Jefferson City, MOBachelor of Science - Business Administration
Lincoln University
Jefferson City, MOSkills
- Medical Terminology
- Manage Records
- Organizational Skills
- Documentation Research
- Prior Authorization Processing
- Insurance Plan Verification
- Claims Preparation
- Work Organizing and Prioritizing
- Medical Terms and Procedure Knowledge
- Customer Experience
- Work Organizing and Prioritizing
- Medical Terms and Procedure Knowledge
Timeline
Patient Care Coordinator
Wellcare Health Plans
06.2019 - Current
Case Manager
RemX/Mckesson
09.2018 - 02.2019
PRIOR AUTHORIZATION ASSOCIATE
Wipro Infocrossing
09.2014 - 06.2018
PHARMACY TECHNICIAN
Walmart Pharmacy
09.2011 - 07.2014
DEALER LICENSING TECHNICIAN
Missouri Department Of Revenue
10.2003 - 08.2004
TAXATION CLERK
Missouri Department of Revenue
10.2003 - 08.2004
MEDICARE CLAIMS PROCESSOR
National Heritage Insurance Company
10.1998 - 10.2000
Bachelor of Science - Business Administration
Columbia College
Bachelor of Science - Business Administration
Lincoln University
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