DANIGEA ANDREWS
Rocky Mount,NC
Summary
Healthcare reimbursement and case management specialist with 5+ years of experience supporting specialty pharmacy and oncology programs. Skilled in prior authorizations, benefits investigations, appeals, and patient access coordination. Known for improving workflows, resolving complex insurance barriers, and ensuring patients receive timely access to critical therapies. Strong track record of working collaboratively with providers, payers, and patients while maintaining compliance and accuracy.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Prior Authorization Coordinator
Wilson Radiation Oncology
08.2024 - Current
- Obtains prior approval from patient’s health insurance plan before moving ahead with radiation treatments, procedures, and/or scheduling diagnostic imaging to ensure health insurance claims are processed and paid correctly
- Communicates internally with clinic personnel to obtain radiation treatment planning information and facilitate prior authorizations and appeals for pre-service denials if needed
- Completes medical necessity paperwork and submit to/follow-up with various insurance carriers
- Reviews and appeals rejected claims
- Spends significant time on the phone talking to insurance companies and 3rdparty vendors
- Works with various business office departments to streamline processes and ensure timely accurate billing
- Completes the Morbidity and Mortality reports at the end of each month to track if patients had any interruptions during radiation, toxicity levels assessed at a level 3 or greater, and/or if any patients expired within 2 weeks of completing therapy.
Reimbursement Case Manager
Biologics By McKesson
11.2021 - 08.2024
- Processed medical claims and billing while guiding patients and families through insurance and financial assistance options.
- Verified eligibility for drug benefits; served as liaison between patients, providers, and insurance companies.
- Secured copay and free-drug assistance by coordinating with third-party entities and support programs.
- Initiated and tracked prior authorizations using clinical notes via portals, phone, and fax.
- Documented all communication in Biologics MIS to ensure compliance and continuity of care.
- Coordinated prescription triage to pharmacies or hubs when Biologics could not dispense.
- Handled high-volume inbound calls from patients, physicians, and clinics regarding coverage and support programs.
- Reported adverse events (AEs) and product complaints (PCs) to clinical staff.
Benefits Verification Representative
CVS Healthcare
05.2020 - 11.2021
- Verified pharmacy benefits for specialty medications.
- Contacted insurance companies to determine levels of coverage and benefits information for patients.
- Assist HCPs with pharmacy claim status.
- Obtained prior authorizations approval and denials.
Case Manager
Englewood Ob/Gyn Associates
03.2016 - 05.2018
- Scheduled, rescheduled, and handled cancelled appointments for patients.
- Obtained payments from patients and scanned identification and insurance cards.
- Verified benefits for medical procedures.
- Obtained prior authorization details if required.
- Checked patient data including insurance, demographic and health history to ensure all information was current.
- Ordered all office supplies including ink cartridges, toner, and paper.
- Always adhered to strict HIPAA guidelines according to company policy.
Customer Retention Representative
CenturyLink
04.2017 - 01.2018
- Ensured superior customer experience by addressing customer concerns, demonstrating empathy, and resolving problems on the spot.
- Built long-term customer relationships and advised customers on purchases and promotions.
- Learned, referenced, and applied product knowledge information.
- Answered an average of 50 calls per day by addressing customer inquiries, solving problems, and providing new product information.
- Promoting and selling CenturyLink products and services on every call to all residential customers.
Education
Associate of Applied Science - Business Administration
Nash Community College
Rocky Mount, NC08.2026
High School Diploma - undefined
Opportunities Industrialization Center
Rocky Mount, NC06.2017
Skills
- Microsoft Office Suite (Word/Excel/PowerPoint)
- MediTech
- Aria (Varian)
- R1 Insurance System
- Benefits Investigation
- Data Entry
- Strong understanding of HIPAA and privacy laws Patient/Provider/Client Services/Prior Authorization/Appeals/Claims
- Consumer Relations
Certification
- Licensed NC Real Estate Broker
- Licensed NC Insurance Producer
Timeline
Prior Authorization Coordinator
Wilson Radiation Oncology
08.2024 - Current
Reimbursement Case Manager
Biologics By McKesson
11.2021 - 08.2024
Benefits Verification Representative
CVS Healthcare
05.2020 - 11.2021
Customer Retention Representative
CenturyLink
04.2017 - 01.2018
Case Manager
Englewood Ob/Gyn Associates
03.2016 - 05.2018
High School Diploma - undefined
Opportunities Industrialization Center
Associate of Applied Science - Business Administration
Nash Community College
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