Summary
Overview
Work History
Education
Skills
Timeline
Generic

Francine Jimmy

Phoenix,AZ

Summary

Accomplished and certified Pharmacy Technician with over 8 years of experience in retail pharmacy environments for major national chains. Practiced at billing insurance for both customer services and medications, offering information to insurance companies and communicating with healthcare professionals. Knowledgeable about HIPAA guidelines, pharmacy practices and pharmacy billing.

Overview

10
10
years of professional experience

Work History

Certified Pharmacy Technician

Amazon Pharmacy
11.2020 - Current
  • Enhance patient care by accurately billing and processing prescriptions in a timely manner.
  • Ensure medication safety with thorough verification of prescription orders.
  • Maintain accurate billing and shipping information for processing and insurance processes.
  • Collaborate with pharmacists to resolve medication-related issues.
  • Manage insurance billing and claims processing, streamlining the reimbursement process for patients and pharmacy.
  • Implemente measures to minimize wait times for prescription pickups, enhancing overall customer experience.
  • Coordinate communication between healthcare professionals to ensure seamless patient care transitions between providers or facilities.
  • Participate in continuous professional development opportunities to stay current on industry standards and advancements in pharmaceutical care.
  • Consult with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
  • Review and verify customer information and insurance provider information.
  • Communicate directly with doctors offices via telephone, fax and email.
  • Communicate with prescribers to verify medication dosages, refill authorizations, and patient information.
  • Resolve non-routine issues like third-party billing, computer system, and customer service issues.
  • Collect co-payments or full payments from customers.
  • Resolve third-party billing, computer system and customer service issues.
  • Set up and modify patient profiles to include current medications and insurance details.

Insurance Billing Specialist

PharMerica
01.2016 - 10.2020
  • Enhanced claim accuracy by meticulously reviewing and verifying patient insurance information.
  • Streamlined billing for Long Term Care, Skilled Nursing and Assisted Living patients.
  • Reduced processing time with thorough pre-authorization requests, ensuring prompt approvals for patients LTC, SNF and AL medication.
  • Increased revenue collection by diligently pursuing outstanding claims and negotiating with insurance companies.
  • Maintained working relationships with insurance providers, keeping open communication channels for claim resolution.
  • Collaborated with medical staff to obtain necessary documentation, enabling timely submission of accurate claims.
  • Conducted periodic audits to ensure compliance with company regulations and to maintain the integrity of billing operations.
  • Implemented improvements in record-keeping practices, resulting in better organization and ease of access for future reference.
  • Provided exceptional customer service to nursing staff when discussing billing matters, demonstrating empathy and professionalism at all times.
  • Ensured strict adherence to HIPAA guidelines while handling sensitive patient information during the billing process.
  • Assisted colleagues during peak workload periods, demonstrating strong teamwork and commitment to overall departmental success.
  • Stayed up-to-date with company developments and changes in insurance policies to ensure ongoing compliance and adaptability in billing practices.
  • Responded to nursing staff concerns and questions on daily basis.
  • Used data entry skills to accurately document and input statements.
  • Collaborated with customers nurses to resolve disputes.
  • Created improved filing system to maintain secure client data.

Insurance Customer Service Representative

United Healthcare Group
05.2015 - 01.2016
  • Enhanced customer satisfaction by addressing and resolving insurance-related inquiries and concerns.
  • Developed strong relationships with clients, providing personalized service.
  • Provided customers inforamtion on available discounts, promoting loyalty and policy retention through recommendations.
  • Managed high call volume while maintaining professionalism, empathy, and attention to detail in each interaction.
  • Provided exceptional support during annual open enrollment periods, guiding customers through plan selection processes effectively.
  • Reduced claim processing time by collaborating closely with team members to ensure prompt claim resolution.
  • Consistently met or exceeded performance goals related to both sales targets and customer service metrics.
  • Handled sensitive customer information with discretion, adhering to strict data privacy regulations at all times.
  • Participated in ongoing training sessions to remain current on industry developments and improve overall job performance.
  • Assisted colleagues in resolving complex cases by sharing knowledge of policies and best practices when needed.
  • Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
  • Responded to customer requests for products, services, and company information.
  • Documented customer interactions and transactions for accurate, up-to-date records.
  • Fielded customer complaints, escalating complex issues to management for resolution.
  • Assisted customers with completing insurance documents to avoid missed information.
  • Provided primary customer support to internal and external customers.
  • Liaised with insurance carriers to resolve billing errors and discrepancies.
  • Adhered to underwriting, rating and compliance criteria and guidelines to determine associated financial risks.
  • Processed insurance policy cancellations and renewals quickly to meet call time targets.
  • Modified, updated and processed existing policies.
  • Generated, posted and attached information to claim files.
  • Communicated effectively with staff members of operations, finance and clinical departments.
  • Notified insurance agents and accounting departments of policy cancellations and changes.
  • Checked documentation for accuracy and validity on updated systems.
  • Calculated adjustments, premiums and refunds.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Collected premiums and issued accurate receipts.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Determined appropriateness of payers to protect organization and minimize risk.

Customer Support Specialist

Department Of Motor Vehicles
07.2014 - 05.2015
  • Enhanced customer satisfaction by addressing and resolving complex issues promptly and professionally.
  • Streamlined support processes for increased efficiency and reduced response times.
  • Developed strong relationships with clients, resulting in repeat business and positive feedback.
  • Collaborated with cross-functional teams to address customer concerns and improve overall service quality.
  • Analyzed customer feedback data to identify areas for improvement and recommended appropriate solutions.
  • Conducted regular training sessions for new team members, promoting best practices in customer support operations.
  • Responded to customer inquiries and provided technical assistance over phone and in person.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Processed customer service orders promptly to increase customer satisfaction.
  • Answered constant flow of customer calls with minimal wait times.
  • Handled customer inquiries and suggestions courteously and professionally.
  • Offered advice and assistance to customers, paying attention to special needs or wants.
  • Updated account information to maintain customer records.
  • Participated in team meetings and training sessions to stay informed about product updates and changes.
  • Clarified customer issues and determined root cause of problems to resolve product or service complaints.
  • Responded to customer requests for products, services, and company information.
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
  • Provided primary customer support to internal and external customers.
  • Resolved concerns with products or services to help with retention and drive sales.
  • Maintained and managed customer files and databases.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Delivered exceptional customer service experiences by maintaining a positive attitude, active listening skills, and empathetic responses to customer concerns.
  • Participated in regular meetings with management to discuss ongoing departmental challenges and propose actionable solutions.
  • Implemented effective troubleshooting techniques for faster problem resolution and improved customer satisfaction levels.

Education

No Degree - Nursing

Dine Community College
Tsaile, AZ

No Degree - Liberal Arts

Northern
Flagstaff

High School Diploma -

Hopi High School
Keams Canyon

Skills

  • Problem-Solving Skills
  • Regulatory Compliance
  • Prescription Verification
  • HIPAA Compliance
  • Data Entry Accuracy
  • Customer Service
  • Ethical Conduct
  • Medicare and Medicaid Process
  • Pharmacy and Customer Records Management
  • Insurance Billing
  • Insurance Verification
  • Insurance Processing

Timeline

Certified Pharmacy Technician

Amazon Pharmacy
11.2020 - Current

Insurance Billing Specialist

PharMerica
01.2016 - 10.2020

Insurance Customer Service Representative

United Healthcare Group
05.2015 - 01.2016

Customer Support Specialist

Department Of Motor Vehicles
07.2014 - 05.2015

No Degree - Nursing

Dine Community College

No Degree - Liberal Arts

Northern

High School Diploma -

Hopi High School

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Francine Jimmy