Summary
Overview
Work History
Education
Skills
Certification
References
Additionalreferences
Timeline
Generic

ELIZABETH C. DOYLE

New Bedford,MA

Summary

Adept at navigating Medicare, Medicaid, and commercial payer landscapes, I leveraged my expertise in prior authorizations and appeals to enhance patient access to medications at EMD Serono Inc. Building strong relationships, I significantly contributed to process improvements and patient support programs, demonstrating exceptional presentation skills and a commitment to healthcare excellence.

Overview

24
24
years of professional experience
1
1
Certification

Work History

Field Reimbursement Manager

Cencora
09.2021 - Current
  • Engage with customers, leveraging client-approved resources, to educate on access and reimbursement topics.
  • Managed daily activities that support patient access to client products in provider offices.
  • Act as a liaison to other patient assistance and reimbursement support services offered by clients.
  • Educate provider office staff with an understanding of payer coverage for products, including coding, billing, formulary, prior authorizations, and the appeal process.

Medical Reimbursement Specialist

EMD Serono Inc.
Rockland, MA
07.2014 - 09.2021
  • Coordinated major medical and prescription benefit verifications with Medicare, Medicaid, TriCare, and private commercial payers to ensure coverage for a multiple sclerosis biologic Rebif
  • Initiated prior authorizations and appeals on behalf of physician office
  • Enrolled patients into patient assistance programs and non profit organizations for copay assistance
  • Established, managed, and maintained strong relationships by gaining trust and working directly with neurologists and their support staff, non profit copay foundations, specialty pharmacies, company sales force, and company colleagues
  • Field travel 50% per year to support sales team in presenting/educating providers and patients on reimbursement support, copay assistance services

Pharmacy Discharge Liaison Specialist

SouthCoast Hospital Group
New Bedford, MA
01.2013 - 07.2014
  • Expedited the discharge prescription process: initiate contact with third party payers, resolve formulary and coverage issues ie
  • Prior authorizations, and assist in enrolling patient into manufacturer/non profit copay foundations
  • Collaborated and act as liaison with patients, families, interdisciplinary teams, and community contacts to develop prescription discharge plans
  • Developed and maintained positive relationships with site staff, physicians, nurses, patients, current and potential referral sources, and other business partners within the hospital group
  • Create, standardize, and implemented procedures and process improvement practices
  • Understood the SouthCoast Retail Pharmacy business and kept current with industry trends, marketing material, and business jargon

Medical Reimbursement Specialist

EMD Serono Inc.
Rockland, MA
12.2009 - 01.2013
  • Coordinated major medical and prescription benefit verifications with Medicare, Medicaid, TriCare, and private commercial payers to ensure coverage for a multiple sclerosis biologic Rebif
  • Initiated prior authorizations and appeals on behalf of physician office
  • Enrolled patients into patient assistance programs and non profit organizations for copay assistance
  • Established, managed, and maintained strong relationships by gaining trust and working directly with neurologists and their support staff, non profit copay foundations, specialty pharmacies, company sales force, and company colleagues
  • Field travel 50% per year to support sales team in presenting/educating providers and patients on reimbursement support, copay assistance services

Registered Pharmacy Technician

Cardinal Health SpecialtyScripts Pharmacy
Fall River, MA
01.2007 - 12.2009
  • Processed pharmacy insurance test claims to determine coverage for patients medications
  • Billed insurance claims to the proper pharmacy vendor, with the appropriate pharmacy codes ie
  • ICD-9 and J- Codes
  • Initiated prior authorizations for Hepatitis C, Rheumatoid Arthritis, Multiple Sclerosis, Chron's Disease, Psoriasis, HIV, and Oncology therapies
  • Enrolled patients into manufacturer and non profit copay foundations ie
  • The Assistance Fund, Patient Access Network Foundation, Chronic Disease Fund, and Cancer Cares

Registered Pharmacy Technician

Rite Aid Pharmacy
Dartmouth, MA
01.2001 - 01.2007
  • Billed insurance claims to the proper pharmacy vendor, with the appropriate pharmacy codes
  • Controlled inventory of stock, daily warehouse orders, and expired medication
  • Completed data entry and ensured the correct patient, medication, strength, and dose was processed for dispensing
  • Customer Service

Education

Associate of Arts - Concentration in Math & Science

Bristol Community College
Fall River, MA
01.2003

Skills

  • Medicare part D and Medicaid structures/benefits
  • Commercial pharmacy benefit manager payers
  • Manufacturer/Non profit copay foundations
  • Prior Authorizations and Appeals
  • Strong working relationships
  • Presentations

Certification

Massachusetts State Registered Pharmacy Technician, PT8213

References

  • Rebecca Vipon, Supervisor 508-858-6181
  • Candace O'Leary, Manager 774-222-0685

Additionalreferences

Additional References available upon request

Timeline

Field Reimbursement Manager

Cencora
09.2021 - Current

Medical Reimbursement Specialist

EMD Serono Inc.
07.2014 - 09.2021

Pharmacy Discharge Liaison Specialist

SouthCoast Hospital Group
01.2013 - 07.2014

Medical Reimbursement Specialist

EMD Serono Inc.
12.2009 - 01.2013

Registered Pharmacy Technician

Cardinal Health SpecialtyScripts Pharmacy
01.2007 - 12.2009

Registered Pharmacy Technician

Rite Aid Pharmacy
01.2001 - 01.2007

Associate of Arts - Concentration in Math & Science

Bristol Community College

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ELIZABETH C. DOYLE