Results-driven Patient Access Specialist experienced in managing insurance verification, prior authorizations, and patient communication to ensure timely access to care and compliance with regulations. Delivered personalized service through effective patient interaction and meticulous handling of paperwork, leveraging proficiency in MS Office and EHR systems alongside a thorough understanding of medical terminology. Focused on enhancing patient experience and quality of care.
Working with specific disease states, reviewing patient insurance plans, submitting prior authorizations through the appropriate portal (Cover My Meds, Sanford Health Plan, Avera Health Plan etc.). Reviewing patient chart notes for appropriate supporting documentation. If approved, we review patient copays and if appropriate, enroll the patient in copay assistance programs such as foundation grants, manufacturer copay assistance, manufacturer free drug programs and Sanford Prescription Patient Assistance Program. If a denial is received, it is sent to the provider for review and if necessary an appeal is submitted through the appropriate channels. Keeping the patients' charts updated as to where in the process we are at and what steps we have taken or are currently in process of to keep patients and providers updated.. Discussed copay options with patients, addressing their questions and providing guidance on available assistance programs.
Assisted in long-term care pharmacy operations. Proficient in the RX30 pharmacy system.
Duties consisted of order entry, filling medications, familiar with filling of medisets, Opus, and heat
sealed cards. Was responsible for going to facilities to make medication changes including adding and
removing medications, changing MARs (both paper MARs and EMARs). Have worked with Point Click
Care and Residex EMARs.
PTCB Pharmacy Technician Certification
ND Pharmacy Technician Registration