Joyce Adesina

• Responsible for customer service and case management manage time efficiently in order to complete all task within deadlines.
• Work interactively with patients, healthcare providers, pharmacies and manufactures clients.
• Investigating a patient insurance benefits for prescribed medication.
• Submitting prior authorization in order to confirm of medication will be covered and approved.
• Streamlined review process conducted in accordance with the payer utilization management guidelines.
• Support various reimbursement and patient assistant functions.
• Responds to all patient, and provider account inquiries.
• Document all interaction into CareMetx Connect System in compliance with HIPAA regulations.
• Insurance benefits of medical or pharmacy.
• Assist with appeal process and send out statement of benefits (SOB).
• Report AE (Adverse Event

Insurance verification Medical and PBM.

• Managed patient account inquiries, ensuring accurate resolution of billing issues.
• Collaborated with healthcare providers to streamline insurance verification processes for inpatient, residential treatment center (RTC) partial hospitalization program (PHP), Intensive outpatient (IOP), electric shock treatment (ECT.)
• Oversaw training programs for new staff on patient account management systems.
• Implemented process improvements to enhance the efficiency of account reconciliation tasks.
• Perform month end audits on insurance re-verification to determine current or termed coverage and obtain single case agreement.