DELORIS THOMPSON
Dallas,TX
Summary
Healthcare support professional with a strong background in patient registration, insurance verification, prior authorizations, and referral coordination. Recognized for clear communication, accurate documentation, and steady handling of high-volume calls across providers, patients, members, and payers.
Overview
20
20
years of professional experience
Work History
Member Services Representative
Verus-Rx /Pharmacy Insurance
09.2024
- Conducted inbound and outbound calls to members, doctor offices, pharmacies, and third parties to ensure accurate communication and service delivery.
- Resolved prescription drug benefits issues related to claims, formularies, and prior authorizations to support member access to necessary medications.
- Responded to member calls regarding pharmacy benefit coverage and eligibility.
- Verified prescription insurance details using member records and plan information.
- Explained copay, formulary, and prior authorization requirements to members.
Patient Service Representative
USMD Medical Group/Optum
01.2016 - 06.2024
- Managed high volume inbound and outbound calls from healthcare providers, patients, and insurance companies; scheduled appointments, processed referrals, and coordinated lab results, doctor letters, and home health orders while collaborating with nurse practitioners and physicians to facilitate urgent patient diagnoses.
- Registered patients using Optum and USMD Medical Group intake procedures.
- Scheduled appointments and coordinated provider calendars for clinic visits.
- Verified insurance coverage and updated demographic information in patient records.
Patient Access Representative
Sonexus Health Pharmaceuticals
12.2015 - 12.2016
- Processed patient applications for high dollar medication assistance, answered inquiries about application status, determined eligibility per federal poverty guidelines, verified pharmacy coverage, and advised on copay responsibilities.
- Verified patient insurance coverage for specialty pharmaceutical access requests.
- Processed prior authorization forms and supporting documentation for therapy approval.
- Coordinated benefits investigations with payers and patient support teams.
Customer Care Coordinator
AmerisourceBergen Inc.
02.2010 - 11.2015
- Handled high volume outbound and inbound calls to healthcare providers, relayed critical information to field representatives and patients, compiled data for correspondences, resolved complaints, followed up on issue resolutions, and responded to inquiries via email and faxes from physicians.
- Coordinated customer orders through AmerisourceBergen distribution systems and service workflows.
- Responded to customer inquiries about shipments, products, and account status.
- Tracked order issues with operations, logistics, and sales teams.
Customer Service Representative
WEBTPA Insurance
05.2004 - 01.2010
- Managed high-volume inbound calls from healthcare providers and members, processed enrollments and payment transactions, and communicated coverage benefits based on contractual agreements.
- Handled member and provider inquiries for WEBTPA Insurance benefit plans.
- Explained coverage, eligibility, and claims details using WEBTPA Insurance policy guidelines.
- Documented customer calls and case notes in WEBTPA Insurance systems.
Education
Health Information Management
Texas Woman University
09-1987
A.A.S - General Science
Cedar Valley College
05-1987
Skills
- Insurance verification
- Prior authorizations
- Patient registration
- Referral coordination
- Benefits investigation
- Healthcare customer service
Timeline
Member Services Representative
Verus-Rx /Pharmacy Insurance
09.2024
Patient Service Representative
USMD Medical Group/Optum
01.2016 - 06.2024
Patient Access Representative
Sonexus Health Pharmaceuticals
12.2015 - 12.2016
Customer Care Coordinator
AmerisourceBergen Inc.
02.2010 - 11.2015
Customer Service Representative
WEBTPA Insurance
05.2004 - 01.2010
Health Information Management
Texas Woman University
A.A.S - General Science
Cedar Valley College