Crystal Roker
9485 EL Clair Ranch Road,FL
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
27
27
years of professional experience
Work History
Order Entry Customer Service Supervisor
Polaris Pharmacy Services
07.2015 - Current
- Steer daily activities of order entry staff and support with proper entry and refill prescription order procedures
- Contribute to analyzing/assisting all customer service calls, while evaluating staff performance on yearly reviews
- Monitor Medicaid and third-party pre-bill edit report to produce accurate monthly statements
- Confirm patient eligibility and prescription benefits, while updating insurance into system and identifying missing information
- Document and submit insurance claims, including commercial, Medicare, Medicaid and other third-party payers
- Review and audit patient files and authenticate relevant documents to confirm adherence with payer and company regulations and defend third-party audits
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
Medical Record Technician
Med Choice Pharmacy
01.2007 - 07.2015
- Prepared monthly consultants reports for psychotropics, and antibiotics, while updating new accounts, conducting QA audits
- Changed pay status and transcribed nurse, therapist, and doctor notes, while managing resident admission/readmissions and meeting daily/monthly deadlines
- Maintained 1,200 active patient/bed records, while responding to incoming/outgoing phone calls and transcribing physicians/telephone orders into QS1 system.
- Developed strong working relationships with physicians, nurses, and other healthcare professionals to ensure accurate recordkeeping practices were upheld consistently across all departments
Data Entry & Customer Service Supervisor
CompScript Mail Order Pharmacy
Boca Raton, FL
12.1996 - 06.2015
- Championed a customer-centric approach within the team, consistently encouraging empathy and understanding when interacting with clients.
- Organized spaces, materials and catering support for internal and client-focused meetings.
- Promoted a positive work environment through open communication channels, fostering team collaboration and high morale.
- Responded to customer inquiries and resolved complaints to establish trust and increase satisfaction.
- Coached team members to deliver hospitable, professional service while adhering to set service models.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
- Confirm patient eligibility and prescription benefits, while updating insurance into system and identifying missing information.
- Enhanced team productivity through regular coaching, feedback, and performance evaluations.
Gold Team Patient Care Secretary
Hospice of Palm Beach County
01.2006 - 02.2007
- Managed daily high volume of incoming calls from patients, families, and other medical professionals with professionalism and empathy.
- Streamlined communication between medical staff and patients, ensuring timely updates on treatment plans and overall progress.
- Prioritized attention to detail when entering physician orders into electronic health systems, minimizing potential errors and ensuring clear communication for patient care plans.
- Enhanced office productivity by handling and high volume of callers per day using different communication software programs via chart and email.
Data Entry & Medical Records Supervisor/ Medical Records Clerk
CompScript Inc.
06.2003 - 01.2006
- Maintained strict confidentiality of sensitive patient information, adhering to HIPAA regulations and institutional policie
- Maximized team productivity with effective scheduling, task delegation, and performance monitoring.
- Facilitated smooth transitions during mergers or acquisitions, ensuring seamless integration of new medical records into existing systems.
- Transcribed and entered patient medical information into electronic medical records systems.
- Increased accuracy of patient data entry through meticulous attention to detail and cross-referencing information.
- Review and audit patient files and authenticate relevant documents to confirm adherence with payer and company regulations and defend third-party audits
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
- Confirm patient eligibility and prescription benefits, while updating insurance into system and identifying missing information
Education
Diploma in Business Administration - Business Administration
Keiser College
Lake Worth, FL07-2000
Business Administration
Bahamas Hotel Training College
Nassau, Bahamas06-1988
High School Diploma -
Government High School
Nassau, Bahamas06-1985
Skills
- Performance Evaluation
- MS Office
- Data Entry
- Scheduling
- Payroll Administration
- Database Management
- Regulatory Compliance
- Health Insurance Coverage
- Security & Confidentiality
- Decision-Making
- Time Management
- Records Management
- One Call Resolution
- Call Center Operations
- Positive and Constructive Feedback
Timeline
Order Entry Customer Service Supervisor
Polaris Pharmacy Services
07.2015 - Current
Medical Record Technician
Med Choice Pharmacy
01.2007 - 07.2015
Gold Team Patient Care Secretary
Hospice of Palm Beach County
01.2006 - 02.2007
Data Entry & Medical Records Supervisor/ Medical Records Clerk
CompScript Inc.
06.2003 - 01.2006
Data Entry & Customer Service Supervisor
CompScript Mail Order Pharmacy
12.1996 - 06.2015
Diploma in Business Administration - Business Administration
Keiser College
Business Administration
Bahamas Hotel Training College
High School Diploma -
Government High School
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