Caylee Lund

Assist members, Providers, pharmacies, and internal staff with pharmacy inquiries. Answer and conduct inbound and outbound calls with members, Provider offices and pharmacies to provide and ensure first call resolution. Responsible for knowing and interpreting pharmacy and medical benefits as well as commonly-used concepts, practices, and procedures within pharmacy operations. Identify root cause issues to ensure resolution and communicate findings as needed. Thoroughly research issues and take appropriate action to resolve them using the appropriate reference material within turnaround time requirements and quality standards. Engage with caller by asking probing questions to understand the issue and desired outcome. Ensure high quality in all data entry, including requests for prior authorization, overrides and all system documentation. Assist in interpreting prior authorization outcomes/issues and provide options for resolution. Enter pharmacy overrides into system(s) based on approved guidelines. Continue to achieve and exceed metrics goals including but not limited to quality assurance, productivity and adherence. Maintain email communication effectively and send outbound faxes as needed. Perform assigned tasks according to established guidelines. Provide outstanding attention to detail as well as excellent customer service, support, and empathy. Known to be a supportive team member and always willing to be of assistance to others. Strive to exceed performance standards. Comply with all policies and standards.

Awarded employee of the month 10/2025 and employee of the quarter April-June 2025.

Have assisted with override training and new hire (employee joining the team) training.

Administrative: Manage phone calls, emails, faxes. and medical records. Schedule coordination and calendar management for multiple Physicians and Physician Assistant. Obtain information as well as provide feedback to various vendors for services provided. Use coding provided to determine what the patient owes for their visit as well as collect payment. Complete insurance verification prior to each patient's appointment and obtain authorizations and referrals as needed. Prepare all paperwork (encounters/superbills) for upcoming appointments. Coordinate all outgoing and incoming referrals as well as medical records for coordination of care.

Medical: Update and maintain patient medical records at each visit and prepare office visit notes for Provider, Perform various clinical procedures including biopsies, suture removal, staple removal, injections, and wound care. Assist with surgical and cosmetic procedures, Monitor patients throughout appointment/procedure and act accordingly to ensure safety and well-being. Ensure patients understand all information discussed during office visit. Manage prescription refills. Respond to Nurse inquiries and complete prior authorizations for medications as needed. Organize all medication samples provided from vendors for easy access as well as monitor expiration dates to ensure expired samples are disposed of. Always maintain a clean facility and fully stocked rooms.

Administrative: Manage phone calls, emails, and faxes as well as medical records. Schedule coordination and calendar management for multiple Physician Assistants at multiple locations. Log and track all incoming reports/results as well as notify and educate patient of said results. Manage all incoming surgical referrals from outside offices. Report cancers to the state as well as meet any MIPS requirements for the position.

Medical: Update and maintain patient medical records at each visit and prepare office visit notes for Provider. Perform various clinical procedures including biopsies, suture removal, and wound care. Assist with surgical and cosmetic procedures. Monitor patients throughout appointment/procedure and act accordingly to meet their needs to ensure safety and well-being. Ensure patients understand all information discussed during office visit. Manage prescription refills, Nurse inquiries, and complete prior authorizations for medications as needed. Organize all medical samples provided from vendors for easy access as well as monitor expiration dates to ensure expired samples are disposed of. Always maintain clean facility and fully stocked rooms.

Administrative: Manage phone calls, emails and faxes as well as prescription refills, prior authorizations, and medical records. Schedule coordination and calendar management for Physician and multiple Physician Assistants. Log and track all incoming reports/results as well as notify and educate patient of said results. Obtain information as well as provide feedback to various vendors for services provided.

Medical: Update and maintain patient medical records at each visit and prepare office visit notes for Provider. Perform various clinical procedures including biopsies, suture removal, and wound care. Assist with surgical and cosmetic procedures. Monitor patients throughout appointment/procedure and act accordingly to meet their needs to ensure patient safety and well-being. Ensure patients understand all information discussed during office visit. Organize all medication samples provided from vendors for easy access as well as monitor expiration dates to ensure expired samples are disposed of. Maintain clean facility and fully stocked rooms at all times.

Administrative: Manage phone calls and calendar appointments for Physician, Physician Assistant and Esthetician. Implement varios support/coordination tasks as required, including insurance calls, office lunch scheduling and obtaining signatures for vendors. Took initiative and created/updated all office paperwork including interoffice master copies as well as patient paperwork during downtime at the front desk. Learned insurance coding and billing and also took on that position as needed when employee took medical leave or was out.

Medical: Accurately file and locate patient paper charts. Update and maintain patient medical records at each visit and present to Provider during appointment and maintain accurate transcription of the visit. Perform numbing injections and assist the Doctor with surgical and cosmetic procedures. Perform suture removals and provide wound care. Prepare and apply allergy testing (patch testing of 100+ agents per test). Prepare/stock numbing injections (syringes) daily. Organize all medication samples provided from vendors for easy access as well as monitor expiration dates to ensure expired samples are disposed of. Maintain clean facility and fully stocked rooms at all times.