David Youells
Healthcare Professional
Harrisburg,PA
Summary
Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills. Experience in Healthcare, Real Estate, and Business Mergers and Acquisitions. Experience with running projects large and small throughout multiple industries
Overview
13
13
years of professional experience
4
4
Certifications
Work History
Insurance Authorization Specialist
Penn State Hershey Medical Center
07.2021 - Current
- Created various Excel documents to assist with pulling metrics data and presenting information to stakeholders for concise explanations of best placement for needed resources.
- Collected and processed pharmacy data to implement workflow changes
- Created data models to support decision-making processes.
- Lead Projects relating to patient experience
- Completed pharmacy prior authorizations, decisions, and appeals
- Aided in prescription assistance process
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Manage database of roughly 1,200 yearly reauthorizations in addition to all new authorizations for the following adult and pediatric clinics: Asthma, Allergy, Immunology, Pulmonology, and Gastroenterology
Certified Pharmacy Technician
Penn State Hershey Medical Center
12.2016 - 08.2021
- Input all patient data regarding claims and prior authorizations into system accurately
- Reached out to insurance carriers to obtain prior authorization for pharmacy drugs
- Complete prior authorization for Hem/Onc specialty medications prior to the inception of our specialty pharmacy
- Reviewed inpatient and outpatient records and interpreted documentation to identify all diagnoses and procedures
- Consult with insurance company representatives to complete claims processing, resolve concerns and reconcile payments
- Verified eligibility and compliance with authorization requirements for service providers
- Collaborated with PAP to process patients lacking coverage for planned procedures
- Identified, researched and resolved billing variances to maintain system accuracy and currency
- Completed paperwork, entering prescription and insurance or billing information into patient profiles
- Work closely with teams to determine appropriate medications, dosing, and insurance coverage
- Executed billing tasks and recorded information
- Collaborate with nursing, care coordination, and physicians to discharge patients with their medications prior to leaving the hospital
- Data entry prescriptions sent from the medical provider
- Discharge Planning throughout hospital with a program called Rx2Go
- Educating patients throughout the discharge process
- Fulfill readmission goals
- Help pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Lead Certified Pharmacy Technician
Walmart Pharmacy
01.2011 - 12.2016
- Input all patient data regarding claims and prior authorizations into CoverMyMeds accurately
- Tracked referral submission during facilitation of prior authorization issuance
- Completed Medication Reconciliation for Medication Therapy Management
- Completed maintenance medication management for OutcomesMTM and Mirixa MTM
- Reached out to insurance carriers to obtain prior authorization for medication
- Resolved non-routine issues like third party billing, computer system and customer service issues
- Followed up with patients for refill reminders
- Pharmacy billing to insurance companies
- Coordinated with physicians and insurance agency representatives for speedy resolution of prescription discrepancies
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient
- Coordinated verification and filling of more than 500 daily prescriptions in high-volume community pharmacy environment
- Entered around 4000 prescriptions monthly
- Identified, researched and resolved billing variances to maintain system accuracy and currency
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
- Researched ICD-9 and ICD-10 coding discrepancies for compliance and reimbursement accuracy
- Help pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
Realtor
Lime House Realty
09.2021 - Current
- Assisted buyers with finding ideal homes by assessing needs, requirements and budgets
- Reviewed property listings, interviewed potential clients, accompanied clients to properties and effectively communicated condition of sales
- Enter and maintain a CRM
- Create CMA's for listing presentations
- Followed-up escrow process, coordinated contingency removal of property inspection and maintained timely closing of escrow
- Arranged for title searches of properties being sold and gave buyers virtual and physical tours of properties
- Advised sellers on ways to increase curb appeal and make homes more appealing to potential buyers
- Negotiated real estate contracts to navigate transactions between buyers and sellers
- Advised clients on mortgage and housing conditions to identify successful properties and promote customer satisfaction.
Business Intermediary
Transworld Business Advisors
01.2019 - 01.2023
- Liaised between business owners and prospective buyers to facilitate purchase or transfer of ownership
- Negotiated contracts to navigate transactions between buyers and sellers
- Acted as liaison between buyers and sellers to ensure positive experiences for both parties
- Negotiated contracts on behalf of clients
- Create Business Valuations
- Network with past, current, and future business owners
- Maintain a CRM of all contacts made within all industries
- Sold Business Valuations to prospective sellers.
Realtor
Real Broker LLC.
10.2020 - 09.2021
Realtor
EXp Realty
08.2019 - 10.2020
Realtor
United Real Estate
11.2018 - 08.2019
Education
Certificate - Google Data Analytics
Coursera
Online 05.2001 -
Lean Six Sigma White & Yellow Belt - Lean Six Sigma
Six Sigma Academy Amsterdam
Online 05.2001 -
High School Diploma -
Williams Valley Jr Sr High School
05.2005 - 2008.05
Pharmacy technician education - undefined
Pharmacy Technician University - Online
01.2016 - 2016.05
Real Estate Education - undefined
Kaplan Professional - Online
01.2018 - 2018.05
Skills
Documentation Management
Certification
Certified in Google Data Analytics
Timeline
Realtor
Lime House Realty
09.2021 - Current
Insurance Authorization Specialist
Penn State Hershey Medical Center
07.2021 - Current
Realtor
Real Broker LLC.
10.2020 - 09.2021
Realtor
EXp Realty
08.2019 - 10.2020
Business Intermediary
Transworld Business Advisors
01.2019 - 01.2023
Licensed Realtor
11-2018
Realtor
United Real Estate
11.2018 - 08.2019
Real Estate Education - undefined
Kaplan Professional - Online
01.2018 - 2018.05
Certified Pharmacy Technician
Penn State Hershey Medical Center
12.2016 - 08.2021
Pharmacy technician education - undefined
Pharmacy Technician University - Online
01.2016 - 2016.05
Lead Certified Pharmacy Technician
Walmart Pharmacy
01.2011 - 12.2016
High School Diploma -
Williams Valley Jr Sr High School
05.2005 - 2008.05
Certificate - Google Data Analytics
Coursera
05.2001 -
Lean Six Sigma White & Yellow Belt - Lean Six Sigma
Six Sigma Academy Amsterdam
05.2001 -
Certified in Google Data Analytics
2024-01
Six Sigma Yellow Belt
2024-02
Certified Pharmacy Technician
2016-08
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