
Experienced Office Manager and Medical professional with 20 years of experience in overseeing a wide variety of essential business functions. Analytical in optimizing productivity, efficiency and service quality across various offices within diverse environments. Highly organized with strengths in prioritizing tasks and managing deadlines. Dedicated to best-in-class customer service and known for effective problem-solving abilities.
● Process and submit insurance claims to all of our customers
● Analyze and verify all dates of service and billed amounts
● Verify client data for completeness and accuracy prior to billing cycle to ensure excellent customer service
● Communicate with patients by telephone and email in regards to their insurance and/or billing questions
● Research missing and incomplete information resulting in billing errors and denials
● Address insurance, reimbursement, and payment issues as appropriate by communicating with insurance
providers, patients, and pharmacists
● Perform all other adjustments in a timely manner to reconcile accounts and completing unbilled
reconciliations on a weekly basis
● Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete
information, therapy changes and pharmacy or shipping errors
● Complete prior authorizations with attention to detail and accuracy, then have the prepared prior
authorization reviewed by a clinical pharmacist
● Assist the pharmacist in filling prescription items, as permitted by the state board of pharmacy
● Enter patient and order information into the pharmacy system
● Collect, organize, and evaluate patient information
● Receive prescriptions sent electronically from the doctor’s office
● Receive written prescription or refill requests and verify that the information is complete and accurate
●Establish and maintain patient profiles, including lists of medications taken by individual patients
●Process new and refill prescriptions
● Accept customer and prescription information required to process new and refill prescriptions, including refill authorization from doctor offices where permitted by state law
● Communicate with patients by telephone and takes refill requests from patients
● Transfers calls from providers to the pharmacist when necessary
• Consult with insurance companies and local pharmacies for Rx information to assist the pharmacist in clinical concern DUR rejections
•Consult with medical providers for rejection follow up and resolution
Licensed Pharmacy Technician
(Will have National Certification November ‘23)
Licensed Pharmacy Technition-Will be Certified in November
Licensed Pharmacy Technician
(Will have National Certification November ‘23)