Erica Bredfeldt
Gardner,KS
Summary
A highly dedicated professional with extensive expertise in client project delivery, long-term client and brand management, and strategic development for complex programs. Demonstrates a proven track record in managing client expectations, ensuring quality and timeliness, and adhering to SOPs, business practices, and KPIs. Proficient in resolving customer inquiries and educating provider staff on client products, coverage management, and reimbursement strategies.
Overview
13
13
years of professional experience
Work History
National Payer Manager
Telix Pharmaceuticals
07.2024 - Current
- Secure positive coverage guidelines for Telix products with government and commercial payers by building relationships with key stakeholders in these accounts
- Deliver the Value Proposition to expand the product portfolio and indication access
- Manage relationships with State Societies
- Work with CMS and develop strategies to build collaboration
- Present payer updates to the internal and external stakeholder team
- Analyze retrospective payer landscape and advise strategies regarding payors. Modeling these impacts through life-cycle management
- Report on current payer trends that impact Telix products
- Training of Market Access teams regarding payer groups and impact to customers
Field Access Manager
Telix Pharmaceuticals
02.2023 - 07.2024
- Educate provider office staff and practice managers on supporting client products, including in-office administration logistics, buy and bill processes, monitoring, and coverage/payer policy changes within assigned territories
- Train staff on payers' coverage management strategies, including coding, billing, formulary, prior authorization, and appeals
- Identify and address root causes of access or reimbursement issues
- Deliver interactive educational presentations at various provider sites
- Provide information on reimbursement topics related to client products with approval
Senior Reimbursement Specialist
Reimbursement Revenue Solutions
08.2022 - 02.2023
- Conduct benefits reviews, prior authorization assistance, and appeals support
- Provide reimbursement solutions for complex patient access situations using regional reimbursement, distribution, and payer policies
- Collaborate with Market Access Team Managers to escalate and resolve issues
Program Manager
ConnectiveRx
03.2022 - 07.2022
- Ensure timely and quality delivery of client projects
- Maintain long-term client/brand management relationships
- Manage client expectations, documentation, and offer solutions for program success
- Contribute to the development and execution of client strategies for complex programs
- Ensure client satisfaction by adhering to SOPs, business practices, and KPIs, resolving issues promptly
- Monitor billing and budgets, identify scope changes, and manage change requests
- Prepare and present Quarterly Business Reviews
Sr. Operations Analyst
ConnectiveRx
07.2021 - 03.2022
- Analyze current operations through data mining, case auditing, and SOP/process flow analysis to identify gaps
- Collaborate with operations teams to develop and implement process for continuous improvements
- Support meeting preparation and participate in biweekly and quarterly business reviews
- Generate and deliver weekly, monthly, and ad hoc reports using web management tools and Excel
- Resolve daily customer inquiries for the Customer Care program via phone and email
Case Manager
ConnectiveRx
05.2019 - 07.2021
- Conduct benefits reviews, prior authorization assistance, appeals support, and initiate co-pay and patient assistance programs
- Provide reimbursement solutions for complex patient access issues using regional reimbursement, distribution, and payer policies
- Collaborate with Access and Reimbursement Managers to escalate and resolve issues
- Educate providers and facilities on coding products, including billing for new drugs/biologicals with miscellaneous J-Codes
- Manage ZenDesk forms, fields, and reporting for HemOnc and Customer Care programs
- Generate weekly, monthly, and ad hoc reports using web management tools and Excel
- Resolve daily customer inquiries for the Customer Care program via phone and email
Patient Reimbursement and Assistance Services Mana
Reimbursement Revenue Solutions
03.2014 - 04.2019
- Oversee day-to-day operations of patient reimbursement and assistance programs for two pharmaceutical clients with four oncology and radiology products
- Research national third-party payer overviews to determine coding, coverage, billing, and reimbursement
- Assist with HCPCS coding, pass-through, and NTAP applications
- Support strategic business, market research, and product planning services for procedures, supplies, drugs, and biologicals
Reimbursement Counselor II
McKesson Specialty Health
08.2011 - 02.2014
- Function as a liaison between the company, patients, insurance, Pharma, and provider offices via phone, fax, and email
- Conduct benefits reviews, prior authorization assistance, and appeals support, initiate copay and patient assistance programs
- Research insurance coverage criteria and authorization forms via payer websites and portals
- Generate weekly reports using web management tools and Excel
Education
Certified Professional Biller (CPB) -
AAPC
Salt Lake City, UT03.2024
High School Diploma -
Wellsville High School
Wellsville, KS05.2003
Skills
- Operational Execution and Management
- Strategic Cross-functional Collaboration
- Compliance and Quality Assurance
- Continuous Process Improvement
- Policy Adherence
- Provider and Patient Advocacy
- Data Analysis
Timeline
National Payer Manager
Telix Pharmaceuticals
07.2024 - Current
Field Access Manager
Telix Pharmaceuticals
02.2023 - 07.2024
Senior Reimbursement Specialist
Reimbursement Revenue Solutions
08.2022 - 02.2023
Program Manager
ConnectiveRx
03.2022 - 07.2022
Sr. Operations Analyst
ConnectiveRx
07.2021 - 03.2022
Case Manager
ConnectiveRx
05.2019 - 07.2021
Patient Reimbursement and Assistance Services Mana
Reimbursement Revenue Solutions
03.2014 - 04.2019
Reimbursement Counselor II
McKesson Specialty Health
08.2011 - 02.2014
Certified Professional Biller (CPB) -
AAPC
High School Diploma -
Wellsville High School
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