Jean Nicole Alder
Rosharon,TX
Summary
Accomplished Patient Care Coordinator with a proven track record, adept in benefit verification and patient onboarding. Expertly navigates prior authorization processes, enhancing financial assistance and patient care coordination. Demonstrates exceptional time management and team leadership, significantly improving operational efficiency and patient satisfaction.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Medication Access Specialist
Ochsner Outpatient & Home Infusion Pharmacy
New Orleans, LA
03.2024 - Current
- Processes patient on-boarding
- Completes benefit verification process and delivers patient estimated responsibility
- Coordinates with providers and patients to assess eligibility for financial support
- Navigates the medication authorization process
- Collects patients’ prescription benefit information
- Communicates and directs all questions or inquiries from patient or families that are outside the scope of taking the medication history to the appropriate caregivers or staff
- Provides high quality customer service to patients, family members, and care team members
- Documents all appropriate findings into the EHR for ease of collaboration amongst providers, support staff, and other refill clinic staff
- Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style
Clearance Specialist
Soleo Health
Frisco, TX
04.2022 - 03.2024
- Perform benefit verification of all patient insurance plans including
documenting coverage of medications, administration supplies, and
related infusion services - Responsible to document all information related to coinsurance, co pay,
deductibles, authorization requirements, and etc - Calculate estimated patient responsibility based off benefit verification and
payer contracts and/or company Self Pay pricing
Initiate follow up, and secure prior authorization, pre-determination, or
medical review including reviewing and obtaining clinical documentation
for submission purposes - Communicate with patients, referral sources, other departments, and any
other external or internal customers regarding status of referral coverage
and/or other updates as needed - Refer or assist with enrolling any patients who express financial necessity
for manufacturer co pay assistance programs or foundations - Generate new patient start of care paperwork
Lead Patient Care Coordinator
Coram/CVS Specialty Infusion Services
Houston, TX
11.2007 - 04.2022
- Ensure smooth operations by acting as first point of contact for new and
existing accounts, while gathering demographics and insurance
information on patients over phone to start admission process for patient
referrals - Initiate and organize new / travelling patient referrals by coordinating with
numerous referral sources all over Texas and United States through phone
Leverage professional expertise by gathering patient liability, initiating
payment arrangements, discussing payment options, and screening for
eligibility to defend financial integrity of facility - Provide exceptional support by liaising with medical professionals and
insurance company personnel to accelerate patient eligibility into program
by instigating approvals for high dollar specialty medications and nursing
services - Deliver optimum services to obtain necessary data / signatures, review
compliance system, and communicate information to patient / guarantor to
ensure medical compliance - Guarantee reporting accuracy and outcomes by finalizing data entry,
including ICD-10 diagnosis coding, while examining computerized reports
to avoid delays in customer billing information - Demonstrate abilities to fulfill requirements for mandatory / continuing
education, develop skills competency, support department-based goals,
and contribute to success of organization by improving individual
professional growth and development - Steered significant efforts to mitigate reimbursement issues with accounts,
sales force, and management - Functioned as preceptor, mentor, and resource to new staff to enhance
operational efficiency, while leading team during Epic roll out
Education
High School Diploma -
Stanford High School
Stanford, MT05-2002
Skills
- Patient onboarding
- Benefit verification
- Prior authorization
- EHR documentation
- Financial assistance
- Team coordination
- Time management
- Regulatory compliance
Certification
PACS | Prior Authorization Certified Specialist - ACMA: 01/25
CPC Certification Course: Medical Coding, 11/2021
Coding Clarified - Coeur D'Alene, ID
References
References available upon request.
Timeline
Medication Access Specialist
Ochsner Outpatient & Home Infusion Pharmacy
03.2024 - Current
Clearance Specialist
Soleo Health
04.2022 - 03.2024
Lead Patient Care Coordinator
Coram/CVS Specialty Infusion Services
11.2007 - 04.2022
High School Diploma -
Stanford High School
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