COURTNEY SIMMONS
Orlando,FL
Summary
Detail-oriented and patient-focused Access Specialist with over five years of experience in patient support and call center environments. Expertise in managing patient information while ensuring compliance with healthcare regulations. Strong analytical, communication, and teamwork skills facilitate quick adaptation to new challenges and environments. Committed to contributing to team success and fostering professional growth, bringing a positive attitude and dedication to continuous learning.
Overview
5
5
years of professional experience
Work History
Patient Access Specialist
AssistRx
10.2023 - Current
- Led initiatives to enhance patient access to essential medications and therapies. Engaged with healthcare providers and insurance entities to streamline information gathering regarding patient insurance and pharmaceutical product coverage. Provided expert guidance to healthcare providers on coding, billing, and complex reimbursement issues. Oversaw prior authorization processes for a designated caseload and directed navigation of appeals for medication access.
Patient Care Advocate
Cigna
03.2023 - 11.2023
- Achieved high levels of member satisfaction by effectively addressing inquiries related to medical claims, benefits eligibility, and prior authorization through inbound calls. Delivered consistent performance by managing 50-80 calls daily, utilizing multiple applications to provide timely assistance. Enhanced member well-being by focusing on individual needs and ensuring positive outcomes. Resolved complaints efficiently, demonstrating strong problem-solving skills and achieving one-call resolutions. Contributed to call center success by consistently providing accurate information and maintaining a professional demeanor.
Quality Assurance Specialist
TetraTech Inc
08.2022 - 12.2022
- Oversaw case reviews to ensure accuracy and compliance with program eligibility standards. Developed comprehensive budgets for funding allocations. Offered strategic guidance to eligibility specialists to enhance performance. Addressed issues promptly, prioritizing based on impact. Monitored and documented defects and resolutions meticulously.
Case Management Eligibility Specialist
TetraTech Inc
07.2021 - 08.2022
- Achieved high-quality application reviews by effectively responding to applicant questions and providing valuable feedback. Enhanced submission processes through collaboration with management to implement best practices. Developed customer service scripts that improved overall applicant satisfaction.
Education
High School Diploma -
Harlan Community Academy
Chicago, ILSkills
- Proficient in prioritizing tasks
- Strong verbal communication
- Skilled in Microsoft software applications
- Experience with Salesforce systems
- Skilled in managing demanding workloads
- Execute data quality checks
- Understanding of medical and pharmacy benefit structures
- Ability to work remote
Timeline
Patient Access Specialist
AssistRx
10.2023 - Current
Patient Care Advocate
Cigna
03.2023 - 11.2023
Quality Assurance Specialist
TetraTech Inc
08.2022 - 12.2022
Case Management Eligibility Specialist
TetraTech Inc
07.2021 - 08.2022
High School Diploma -
Harlan Community Academy