Highly motivated professional with a strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working independently, and quickly mastering new systems. Experienced in utilizing multiple electronic health record (EHR) platforms and salesforce to support efficient workflow and accurate documentation.
Overview
13
13
years of professional experience
Work History
Insurance Specialist, II
Abbvie Endocrinology
05.2022 - 05.2023
Provided subject matter expertise and exceptional customer service for inbound and outbound calls, achieving first call resolution by delivering insurance coverage, verification details, prior authorization statuses, and alternate funding options for products. Supplied offices with current plan forms, portals, and websites for prior authorizations and appeals; communicated investigation results clearly to customers.
Investigated and resolved escalated patient issues, including complex access challenges, savings/copay card difficulties, and non-preferred formulary problems. Conducted benefit investigations and engaged with HCPs, patients, pharmacies, or payors as needed.
Documented information accurately in the appropriate system of record, communicating insurance details to HCPs and patients via phone and electronic communication methods, adhering to established policies and procedures.
Quickly learned and executed business processes and system changes for all drugs and channel sources. Maintained understanding of current business procedures, deviations, and case processing for all brands and channel sources.
Identify potential Adverse Event situations for reporting to Pharmacovigilance ensuring AbbVie meets FDA regulations.
Patient Access Representative
Children's Hospital of Richmond at VCU
Fredericksburg, VA
11.2019 - 04.2022
Facilitated patient registration and appointment scheduling for various medical services.
Verified patient check-ins and check-outs, updating information and collecting outstanding balances.
Organized intakes, providing therapists with comprehensive visit information.
Ensured precise therapist scheduling and accurate patient appointments.
Collaborated with clinical teams to enhance patient transitions and care coordination.
Maintained accurate patient records in electronic health record system diligently.
Managed insurance verification and authorization for scheduled appointments.
Entered and maintained insurance data in electronic health record systems.
Assisted patients in understanding their insurance coverage and benefits.
Maintained accurate patient records in electronic health record system diligently.
Received recognition from colleagues for exceptional patient service.
Office Manager
Vista Eye Specialist
Fredericksburg, VA
03.2010 - 11.2019
Managed daily office operations and maintained efficient workflow.
Developed and implemented office procedures for improved efficiency.
Coordinated schedules for 3 doctors and 10+ employees to optimize workflow.
Managed billing processes to ensure timely submissions for 3 doctors and testing appointments, enhancing cash flow.
Resolved patient complaints and addressed billing inquiries promptly.
Handled IT issues to maintain operational continuity.
Conducted daily and monthly reconciliations of all payments across locations.
Maintained accurate patient accounts, ensuring correct payment allocations and refunds.
Monitored collection accounts and allocated payments to maintain accurate financial records.
Created and reconciled spreadsheets for cash payments on non-covered services.
Supervised administrative staff and provided training on best practices.
Ensured compliance with healthcare regulations and maintained patient confidentiality.
Assisted in financial management, including billing and invoicing processes.
Processed prior authorization requests for medical procedures and services.
Built and maintained relationships with 10+ local optometry offices, strengthening referral partnerships and positioning the practice as a preferred provider for specialized ophthalmologic care.
Educated and supported referring optometrist on advanced ophthalmic technologies and post-surgical patient management to ensure optimal continuity of care.
Created a patient tracking system to monitor co-managed cases, ensuring all pre-operative, surgical, and post-operative records were complete, accurate, and submitted promptly.
Patient Financial Advisor II & Insurance Specialist II at UT Southwestern University Of TexasPatient Financial Advisor II & Insurance Specialist II at UT Southwestern University Of Texas
Insurance Billing Specialist II at Washington University School of Medicine RadiologyInsurance Billing Specialist II at Washington University School of Medicine Radiology