DIANA PEDROZA

• Medication Prior Authorizations
• NC Medicaid Drug List
• Via CoverMyMeds & NC Tracks
• Verify Insurance eligibility check
• Obtained and logged accurate patient insurance and demographic information for use.
• Collaborated with Nurse Practitioners to seek alternatives for patients lacking coverage on requested medication by the prescriber
• Developed extensive fact-checking and research skills to tired and failed medications for preferred medications
• Connections with Psych medication reps ex: Vraylar, Quebree, Latuda etc. for quicker approvals
• Communication with the front desk office of letting patients know of their status on Prior authorizations

• Assist our RN with calling in patient prescriptions
• Calling Pharmacies for new or refill request

• Behavioral Health Facility

Front Desk

• Managed over 20 calls per day
• Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
• Coordinated patient scheduling, check-in, check-out and payments for billing.
• Checked patient insurance, demographic and health history to keep information current.
• Transcribed phone messages and relayed to appropriate personnel.
• Kept waiting room neat and organized by stacking magazines, removing trash and cleaning glass.
• Helped patients complete necessary medical forms and documentation.

• Drug & alcohol rehabilitation center
• COVID ward; PPE
• Vitals
• MA float for 20+consumers
• New patient intake
• Upon admission check belongings for any electronic devices, weapons, sharp objects that can harm them or others
• Preformed Tb readings and testing, drug test, urine testing
• Send and request rx refills via fax to pharmacy using KIPU
• Basic Wound Care

• Adhered to company policies and scripts to consistently achieve call-time and quality standards.
• Enhanced office efficiency by handling [200]+ callers per day
• Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing
• Coordinated patient scheduling, check-in, check-out and payments for billing
• Received, recorded and addressed incoming and outgoing communication via telephone and email
• Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
• Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.