JULIA BERG
Maywood,IL
Summary
Accomplished professional with expertise in claims review and appeals support at CVS Pharmacy. Proven ability to resolve complex insurance issues, leveraging strong analytical thinking and communication skills. Excel in maintaining HIPAA compliance and managing high-volume workloads, ensuring timely resolutions and customer satisfaction. Adept in Microsoft Excel and Word, enhancing documentation accuracy and efficiency.
Overview
11
11
years of professional experience
Work History
Pharmacy Technician
CVS Pharmacy
Illinois
02.2025 - Current
- Reviewed and processed multiple prescription insurance claims, resolving rejected or denied claims to facilitate approval
- Analyzed insurance responses to determine next steps, ensuring potential claim approvals
- Communicate with insurance providers and patients to resolve claim discrepancies and coverage issues
- Documented claim activity and resolutions in pharmacy systems to maintain accurate records
- Maintain strict HIPAA compliance when handling patient and insurance information
- Prioritize high-volume claim issues to ensure timely resolution and customer satisfaction
Patient Access Representative
Duly Health and Care
Remote
01.2021 - 11.2024
- Assessed patient needs and prioritized urgent requests, coordinating same-day care to enhance patient satisfaction
- Managed high-volume inbound calls, facilitating patient scheduling, prescription requests, and care coordination for optimized patient experience
- Documented all patient interactions meticulously, ensuring continuity of care and supporting effective follow-up
- Communicated with internal departments to ensure efficient resolution of patient needs
- Maintained HIPAA compliance at all times
Medicare Care coordinator
Best foot forward
Maywood, IL
01.2015 - 02.2021
- Conducted outreach to individuals to facilitate the completion of Medicare medical assessments for major insurers, including Humana, Aetna, and United, ensuring a supportive and informative environment.
- Verified and updated patient information in compliance with Medicare guidelines, addressing discrepancies and maintaining accurate records.
- Educated beneficiaries on their Medicare benefits, providing detailed explanations to enhance understanding and utilization of services.
- • Trained colleagues in effective communication techniques and best practices for engaging patients over the phone, improving assessment completion rates.
- • Collaborated with healthcare providers to ensure seamless communication and follow-up on patient assessments and benefits.
- • Assisted in the enrollment process, guiding individuals through necessary documentation and eligibility requirements.
Education
High School Diploma -
Thorndridge High School
Dolton, IL01-2010
Skills
- Medication Management
- Prescription Processing
- Patient Record Maintenance
- Patient Consultation
- HIPAA Compliance
- Data Entry & Accuracy
- Microsoft Excel & Word
- Problem Solving & Analytical Thinking
- Time Management & Prioritization
- Communication (Written & Verbal)
- Patient Advocacy
Timeline
Pharmacy Technician
CVS Pharmacy
02.2025 - Current
Patient Access Representative
Duly Health and Care
01.2021 - 11.2024
Medicare Care coordinator
Best foot forward
01.2015 - 02.2021
High School Diploma -
Thorndridge High School