Deborah McTighe

• Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
• Educated clients on available programs, benefits and services, empowering them to make informed decisions about their care needs.
• Improved client satisfaction by efficiently addressing concerns or grievances in a timely manner.
• Assisted patients with patient enrollments, Benefit Investigation, rebate Reprocessing and Escalation.
• Provided inbound and outbound phone support and serve as the primary contact for patients, caregivers and providers.
• January 2023 to May of 2024
• Assisted with the start up of a new program to support patients who were no longer eligible with a foundation that was providing financial assistance.
• Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.

Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.

Maintained through knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.

Analyzed medical records and other documents to determine approval of requests for authorization.

Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.

Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.