HALEY PESAVENTO

• Educates and assists physician offices with prior authorizations

• Drafts appeal letters for physician review and assists with appeal submission

• Communicates with insurance companies to discuss denial reasons and advocate for medical necessity

• Reviews clinical documentation required to meet plan approval

• Works in a team environment and presents weekly cases to cross functional team members

• Communicates with cross functional team members to create a plan of action for patient care

• Advocates for patients dealing with rare diseases

• Monthly outreach to patients to set up medication refills

• Assisted with enrolling patients and prescribers into the REMS program

• Discussed adverse events with patients and reported to the physician’s office and manufacturer

• Assisted offices with questions regarding medication and program requirements

• Administered injectable medications to pediatric and adult patients

• Assisted physicians with medical procedures

• Triaged patient phone calls

• Trained new RN hires on the office processes

• Provided medication clarifications and verbal orders to pharmacies

• Helped lead and prepare office staff in Joint Commission meetings

• Instrument sterilization

• Completed medication and medical prior authorization

• Drafted appeal letters for physicians review and assisted with submission to insurance plans

• Assisted with scheduling patients for appointments and procedures

• Completed data entry for customer orders and weekly sales

• Assisted with creating templates for customer orders

• Processed weekly customer payments

• Assisted manager of the company with various needs around the office