Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Interests
Timeline
Dewanna Gaskew

Dewanna Gaskew

Lewisville,TX

Summary

Dependable specialist serving diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Experienced Access Specialist with over 18 years of experience in healthcare. Excellent reputation for resolving problems and improving customer satisfaction.

Professional coordinator with proven track record in managing complex projects and driving efficiency. Skilled in strategic planning, resource allocation, and cross-functional collaboration. Known for adaptability, reliability, and delivering consistent results in dynamic environments. Strong communication, problem-solving, and organizational skills enhance team performance and ensure successful outcomes.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Senior Coordinator/ARM Support Representative

Cardinal Health
03.2022 - Current
  • Responsible for efficiently processing inbound faxes and accurately entering data
  • Responsible for handling inbound and outbound calls, with ability to determine needs and provide one call resolution
  • Responsible modify process to resolve situations.
  • Create and complete accurate referrals and applications and keep updated on policy or procedural changes and educate of findings
  • Investigate and resolve patient/physician inquiries and concerns in a timely manner
  • Enter detailed information into company proprietary software while conversing via telephone
  • Place outbound phone calls for ARM follow ups or confirmations
  • Work independently within established procedures
  • Interact with the patient referral sources to process new applicants
  • Steward patient accounts from initial contact through final approval/denial
  • Prioritize multiple, concurrent assignments and work with a sense of urgency
  • Maintaining quality and providing an empathetic and supportive experience to the patient by controlling the patient conversation, educating the caller as they provide effective and efficient strategies and processes.
  • Follow through on all benefit investigation rejections, including prior authorizations, appeals, etc. All avenues to obtain coverage for the product must be fully exhausted.
  • Serve as liaison between client salesforce.
  • Enhanced team productivity by conducting regular performance reviews and providing constructive feedback.

Access Specialist/Team Leader

CareMetx
10.2021 - 03.2022
  • Under general supervision of Supervisor and Manager, Case Manager is responsible for customer service and case management.
  • Case Manager will work interactively with patients, healthcare providers, pharmacies, and manufacturer clients.
  • Support various reimbursement and patient assistance functions.
  • Case Manager responds to all patient, and provider account inquiries.
  • Documents all interactions into Care Connect system in compliance with HIPAA regulations.
  • Acts as single point of contact and voice for all providers and patients.
  • Serves patient advocate and enhances caller on tact experience.
  • Coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support service.
  • Collects and review all patient information with 95% accuracy.
  • Validates completeness of all required information and helps provider and/or patient.
  • Provide guidance to physician office staff and patients on how to complete and submit all necessary program applications in timely manner.
  • Determine patient's eligibility and conducts patient enrollment activities.
  • Prove exceptional customer service to internal and external customers; resolves any customer requests in timely and accurate manner; escalates complaints accordingly.
  • Maintain frequent phone contact with patients, provider representatives, third party customer service representatives and pharmacy staff.
  • Obtains and provides reimbursement information to providers and/or patients.
  • Work on problems of moderate scope where analysis of data requires review of variety of factors.
  • Exercise judgment within defined standard operating procedures to determine appropriate action.
  • Typically receives little instruction on day-to-day work, general instructions on new assignments.
  • Must be knowledgeable of HIPAA regulations and HIPAA compliant at all times.
  • Perform related duties as assigned.
  • Ability to multi-task and adapt to changing priorities.
  • Demonstrates ability to perform investigations / root cause analysis and develop corrective actions.
  • Utilize understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality planning, validation, CAPA and problem solving.
  • Knowledge of HIPAA regulations.
  • Detailed oriented and highly organized.
  • Excellent inter-personal skills.
  • Knowledge of pharmacy benefits, and medical benefits.
  • Global understanding of commercial and government Insurance.
  • Ability and initiative to work independently or as team member.
  • Demonstrates an understanding of the relevant regulations, standards, and operating procedures.
  • Ability to problem solve.
  • Leveraged knowledge of various software platforms to optimize the management of patient information and streamline daily tasks.
  • Contributed to a positive work environment by actively participating in team meetings, sharing best practices, and providing constructive feedback when necessary.

Field Solutions Coordinator

Cardinal Health
07.2019 - 09.2020
  • Assist patients with applying for insurance assistance for medication and supplies.
  • Create and complete accurate applications for enrollment with a sense of urgency for each patient.
  • Follow through on all benefit investigation rejections, including prior authorizations, appeals, etc. All avenues to obtain coverage for the product must be fully exhausted.
  • Serve as liaison between client salesforce such as specialty Pharmacy and field reimbursement mangers.
  • Support team with call overflow and intake when needed.
  • Also performed Quality Assurance to the team as needed.
  • Managed schedules, accepted time off requests and found coverage for short shifts.
  • Prepared detailed reports on updates to project specifications, progress, identified conflicts and team activities.
  • Participated in cross-functional team-building activities.
  • Established open and professional relationships with team members to achieve quick resolutions for various issues.
  • Continuously checked products for quality assurance according to strict guidelines.
  • Evaluated employee skills and knowledge regularly, training and mentoring individuals with lagging skills.
  • Took on additional job duties during unexpected backlog, resulting in meeting project target date.
  • Trained new team members by relaying information on company procedures and safety requirements.
  • Worked different stations to provide optimal coverage and meet production goals.
  • Operated production machinery safely to reduce workplace accidents.

Senior Case Manager

Cardinal Health
10.2017 - 07.2019
  • Reviews initial referral to determine if additional information will be needed to complete benefit investigation and adheres to the HIPAA Compliance and Privacy Standards Confidentiality Agreement.
  • Verifies patient insurance coverage of medications and related pharmacy services requirement with 100% accuracy.
  • Make outbound call to pharmacy benefit manager to obtain plan information, formulary restrictions and copays on medications.
  • Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry.
  • Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information.
  • Send report and set next follow-up with payers or providers and determine case closure.
  • Provide coaching and training of new team members.
  • Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
  • Educated patients and providers on healthcare protocols and processes.
  • Initiated and created numerous patient referral system, successfully.

Senior Reimbursement Specialist

AmerisourceBergen
07.2012 - 08.2017
  • Resolve patient's questions and concerns regarding the status of their request in timely manner.
  • Maintain quality while providing an empathetic and supportive experience to patients, providers and physician offices.
  • Enter sensitive patient information retrieved via phone, fax and email.
  • Review, audit and process claims received from providers.
  • Mentor new hires to ensure quality and accurate knowledge and performance.
  • Place outbound calls to patients to assess eligibility, copay and financial assistance.
  • Steward patient accounts from initial contact through final approval and/or denial.
  • Contact insurance companies and pharmacies to verify benefits.
  • Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
  • Prevented delays and claim denials by correcting information prior to submission.
  • Delivered timely information to insurance representatives to resolve common and complex issues.
  • Contributed knowledge to help improve financial management, billing and tracking systems.
  • Performed state and federal regulations compliance audits related to documentation and reporting.
  • Followed up on denied and unpaid claims to resolve problems and obtain payments.
  • Monitored and documented accounts receivable trends and account-specific profitability.
  • Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
  • Created documents in accordance with payer guidelines and submitted to appropriate parties.
  • Built proactive, client-specific edits into system to prevent future denials.
  • Employed clinical and billing codes expertise to correct billing inconsistencies.
  • Helped minimize escalations by reaching out to clients in advance of expected problems.
  • Trained department employees in proper billing and healthcare procedures.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.
  • Generated, posted and attached information to claim files.
  • Posted payments to accounts and maintained records.
  • Collected premiums and issued accurate receipts.
  • Checked documentation for accuracy and validity on updated systems.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Acted as subject matter expert, answering internal and external questions and inquiries.
  • Reviewed 20 or more patient cases per week and verified insurance coverage information.
  • Processed and recorded new policies and claims.
  • Communicated verification and authorization status updates with all department to facilitate decision-making for patient admissions and insurance coverage.
  • Verified client information by analyzing existing evidence on file.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Determined appropriateness of payers to protect organization and minimize risk.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Notified insurance agents and accounting departments of policy cancellations and changes.
  • Calculated adjustments, premiums, and refunds.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.

Education

Associate of Science - Business Management

Hinds Community College, Raymond, MS

High School Diploma -

Hinds Agricultural High School
05.1998

Skills

  • Multitasking Abilities
  • ICD -10 coding understanding
  • Payment collection
  • Medical insurance
  • Cultural Awareness
  • Benefit Investigation
  • Team oversight
  • Relationship building
  • Accounts reconciliation
  • Medical billing
  • Problem-solving
  • Verbal and written communication
  • Medical terminology
  • Conflict resolution
  • Document management
  • Support services
  • Account reconciliation
  • Program development
  • Administrative management
  • New hire orientation
  • Phone and email etiquette
  • Discretion and confidentiality
  • Project assistance
  • Meeting facilitation

Accomplishments

  • Collaborated with team of five in the development of ARM Team.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Certification

  • PACS, AACP
  • Prior Authorization Certification Specialist
  • Administrative Assistance Certification Program

Interests

  • Volunteering with youth sports programs as a cheer coach/mentor
  • Participating in local clean-up initiatives
  • Volunteering at community kitchens and food-related charities
  • I like working with my hands and fixing things
  • Fashion and Style
  • Participating in fundraising events to support local charities, schools, or community projects
  • Music
  • Dance
  • Volunteer Work

Timeline

Senior Coordinator/ARM Support Representative - Cardinal Health
03.2022 - Current
Access Specialist/Team Leader - CareMetx
10.2021 - 03.2022
Field Solutions Coordinator - Cardinal Health
07.2019 - 09.2020
Senior Case Manager - Cardinal Health
10.2017 - 07.2019
Senior Reimbursement Specialist - AmerisourceBergen
07.2012 - 08.2017
Hinds Community College - Associate of Science, Business Management
Hinds Agricultural High School - High School Diploma,

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