Summary
Overview
Work History
Education
Skills
Websites
Timeline
Generic

Crystal Roker

Boynton Beach,FL

Summary

Data-driven and highly analytical professional with extensive experience in healthcare administration, records management, and customer service. Proven success in maintaining/updating data management systems, improving order processing, and assessing pre-admission patient status. Demonstrated ability to update medical/treatment records, analyze/mitigate potential risks, and draft insurance claim documents. Adept at ensuring compliance with regulatory requirements. Expert in collaborating with cross-functional teams to achieve collective goals. Recognized for enhancing patient care procedures and defending third-party audits. Thrive in deadline-driven and ever-changing environment.

Overview

17
17
years of professional experience

Work History

Order Entry Customer Service Supervisor

Polaris Pharmacy Services
Lauderdale, FL
01.2015 - Current
  • Steer daily activities of order entry staff and support with proper entry and refill prescription order procedures
  • Analyze employee production level using computer-generated reports to ensure order equity and improved prescription processing
  • 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
  • Uncovered rejected pharmacy claims on time
  • (What were the results of this effort?) Ensured compliance with policies and procedures to confirm uniform/accurate data entry, including new admissions, readmits, and discharge patients’ data.

Medical Record Technician

Med Choice Pharmacy
Cooper City, FL
01.2007 - 01.2008
  • 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.

Gold Team Patient Care Secretary

Hospice of Palm Beach County
Boca Raton, FL

Data Entry & Medical Records Supervisor/ Medical Records Clerk

CompScript Inc.
Boca Raton, FL

Education

Diploma in Business Administration - Business Administration

Keiser College
07-2000

Business Administration

Bahamas Hotel Training College
06-1988

High School Diploma -

Government High School
Nassau, Bahamas
06-1985

Skills

  • Documentation & Reporting
  • Performance Evaluation
  • Database Management
  • Regulatory Compliance
  • Health Insurance Coverage
  • Stakeholder Management
  • Relationship Building
  • Security & Confidentiality
  • Inter-personal Communication

Timeline

Order Entry Customer Service Supervisor

Polaris Pharmacy Services
01.2015 - Current

Medical Record Technician

Med Choice Pharmacy
01.2007 - 01.2008

Gold Team Patient Care Secretary

Hospice of Palm Beach County

Data Entry & Medical Records Supervisor/ Medical Records Clerk

CompScript Inc.

Diploma in Business Administration - Business Administration

Keiser College

Business Administration

Bahamas Hotel Training College

High School Diploma -

Government High School
Crystal Roker