Francis Andasola White
Orlando,FL
Summary
Dedicated professional with a strong focus on accuracy and efficiency, seeking a position to utilize my skills. Committed to creating a motivated, knowledgeable, and productive work environment.
Overview
17
17
years of professional experience
Work History
REMOTE Sr Cdr, Complaint & Appeals Ops
CVS/AETNA
Remote
09.2021 - 10.2024
- Sr Cdr, Complaint & Appeals Ops Aetna Responsibilities were case handling for grievances submitted by members with Medicare Part B & D and Part C plans as well as DSNP and Vendor complaints. Processing and requesting AOR/POA/EOE documents if needed. Researching and classifying cases as inquires or legitimate official grievances and researching the complaints thoroughly with our multiple layered systems to locate information to determine a resolve for the members case.Outbound calls to members for acknowledgment and resolution. Written resolutions if needed.
- FEP (Federal Employee Program)
- CORE (Non Federal /Government)
- GNC (Generic Specialty Medications for Chronic Illness/disease). Responsible for inbound and outbound calls for patients, creating profiles through our intake process and completing specialty pharmacy prescription requests and refills.
- HIPAA verification, demographics, confirming or updating physician information, delivery address verification for shipment of Medication.
- Obtaining and updating Insurance information, adding or updating copay assistance, Processing claims, Reversing claims, Reprocessing claims due to insurance rejections, Processing payments.
- Communicate with our patients or with patients Doctor/Doctor's office in regards to prior authorizations needed or new prescriptions needed, confirming prescription continuation or therapy of medication completed.
- REMS training
REMOTE EXECUTIVE COMPLAINT MANAGER
Wells Fargo
REMOTE
05.2020 - 02.2021
- Responsible for escalated complaints within Wells Fargo for business account customers which were not resolved at branch level.
- I researched the complaints which involved deposit items, wire transfers (domestic & international), origination documents, account reconciliation, fraud claims, online business banking.
- Worked and researched with multiple secured programs to access the appropriate information needed to provide the customer resolution by letter or by phone or email.
PATIENT CARE ADVOCATE
Alliance RX
REMOTE
12.2019 - 03.2020
- Provided customer care service for inbound calls for specialty pharmacy prescription requests and refills.
- Processed shipments of prescription requests by patients, physicians and authorized medical staff.
- Handled calls with empathy and efficiency.
- Responsible for processing payments, updating profiles for correct billing and shipping information, HIPAA verification process, new patient enrollment, obtaining insurance information, connecting patients or physicians to pharmacists for counseling, clinical questions.
REMOTE SENIOR CUSTOMER SERVICE REPRESENTATIVE
Capital One
REMOTE
10.2018 - 10.2019
- Specialized in handling inbound calls related to Small Business credit card accounts, in addition to assisting with the personal credit card accounts occasionally.
- Provided customer service, verification of card holders and accounts, accounts payable, billing, data entry, lost & stolen reports, investigated fraud claims, replacement cards, bank balance verification to release payments to eligible accounts, manual reviews and submission of credit line increase requests.
REMOTE MEDICAL SCHEDULER
Phoenix Practice Solutions
REMOTE
10.2014 - 01.2018
- Company Overview: (Columbia Presbyterian Medical Center NYC)
- Responsible for scheduling patients, registering new patients, customer service, data entry, answering multi phone lines, verifying insurance, prescription requests, corresponding with MD's via internal chat or instant messages and medical record requests for the following departments: Ophthalmology, Otolaryngology, Rehabilitation Medicine, Neurology, Internal Medicine, Pediatrics and Dental.
- (Columbia Presbyterian Medical Center NYC)
MEDICAL FRONT OFFICE ASSOCIATE
Family Medicine Associates
Ithaca, NY
05.2013 - 07.2014
- Responsible for scheduling patients, registering new patients, customer service, data entry, key holder for both office locations, check in & check out, billing, collecting co-pays, accounts receivable, Insurance verification, prescription requests, utilizing EMR (electronic medical record) for patient medical records, daily batches for bank deposits.
CUSTOMER SERVICE REPRESENTATIVE
SunTrust Bank
Orlando, FL
01.2008 - 02.2010
- Provided customer service to the credit card department, data entry, answering inbound calls, billing, data entry, handling elite customer clientele, manual reviews and submission of credit line increase requests.
CUSTOMER SERVICE REPRESENTATIVE/TELLER
Tompkins Savings & Trust
Ithaca, NY
07.2007 - 12.2007
- Bank teller,Key holder, ATM balance of daily account activity report's, customer service, investigated transactions greater than $10,000, filed currency transaction reports (CTRs), vault, opening & closing accounts. Credit card advances, debit card issuance.
Education
Diploma -
Cibola High School
Albuquerque, NMSkills
- CUSTOMER SERVICE
- ANALYTICAL
- CLERICAL ADMINISTRATION
- BILLING/CLAIMS
- SCHEDULING
- ORGANIZATION
- TIME MANAGEMENT
- PROBLEM SOLVING
- ACTIVE LISTENER
- MULTITASKING
- DETAIL ORIENTED
- CRITICAL THINKING
Timeline
REMOTE Sr Cdr, Complaint & Appeals Ops
CVS/AETNA
09.2021 - 10.2024
REMOTE EXECUTIVE COMPLAINT MANAGER
Wells Fargo
05.2020 - 02.2021
PATIENT CARE ADVOCATE
Alliance RX
12.2019 - 03.2020
REMOTE SENIOR CUSTOMER SERVICE REPRESENTATIVE
Capital One
10.2018 - 10.2019
REMOTE MEDICAL SCHEDULER
Phoenix Practice Solutions
10.2014 - 01.2018
MEDICAL FRONT OFFICE ASSOCIATE
Family Medicine Associates
05.2013 - 07.2014
CUSTOMER SERVICE REPRESENTATIVE
SunTrust Bank
01.2008 - 02.2010
CUSTOMER SERVICE REPRESENTATIVE/TELLER
Tompkins Savings & Trust
07.2007 - 12.2007
Diploma -
Cibola High School