Karen R. Cook
Merrillville,USA
Summary
Results-driven manager with a proven track record in optimizing patient access to specialty medications through strategic collaboration with healthcare providers. Expertise in training billing staff on reimbursement processes, leading to enhanced billing efficiency across multiple territories. Demonstrated ability to navigate payer obstacles, ensuring streamlined operations and improved patient outcomes.
Overview
31
31
years of professional experience
1
1
Certification
Work History
Field Reimbursement Manager
Johnson & Johnson
04.2024 - Current
- Access specialist, ensuring patient access to Johnson & Johnson Oncology Medication Portfolio through client support programs
- Facilitated resolution of payer and reimbursement issues for healthcare providers through collaboration with client hub advocates.
- Delivered comprehensive payer coverage information for Medicare, Medicare Advantage, Medicaid, and Commercial Major Medical plans, including Medicare Part D and Pharmacy Benefit Managers.
- Train and educate healthcare billing staff, financial counselors, Prior Authorization teams on proper billing and coding procedures.
- Established and nurtured strong working relationships with clients to enhance support and service delivery.
- Communicate and collaborate with regional managers and field sales managers.
- Acquired in-depth understanding of specialty pharmacy services and their complexities.
Field Access and Reimbursement Manager
Cencora/Xcenda, LLC
05.2018 - 04.2024
- Access specialist, ensuring patient access to medication in neuropsychiatry, neuroscience, and oncology through client support programs.
- Supported healthcare providers in addressing payer and reimbursement challenges through client hub advocacy.
- Delivered comprehensive payer coverage information for Medicare, Medicare Advantage, Medicaid, Commercial Major Medical plans, Medicare Part D, and Pharmacy Benefit Managers.
- Cultivated and maintained strong professional relationships with clients to enhance collaboration and service delivery.
- Communicate and collaborate with client regional and field sales managers.
- Train and educate billing staff on proper billing and coding procedures.
- Oversaw multiple accounts across various territories.
- Possessed extensive knowledge of specialty pharmacy operations.
Adjunct Instructor - Pharmacy Technician Course
Brightwood College
Hammond, USA
02.2018 - 05.2018
- Prepared and trained established curriculum to in-classroom students to prepare for national certification exam.
- Reviewed pharmacy calculations, practice, pharmacology, law, medical terminology, abbreviations, and compounding skills to ensure curriculum accuracy and compliance with standards.
- Facilitated student engagement in classroom exercises to promote active learning and participation.
- Adhered to procedures and policies of the program.
- Maintained effective communication and collaborative work relations with staff to support program objectives.
- Hammond, IN
Specialty Pharmacy Manager/ Practice Manager /Authorization & Benefits Manager /IV Technician
Northwest Oncology, PC
Munster, USA
10.2003 - 12.2017
- Managed operations across three pharmacy locations.
- Obtained insurance benefits and authorizations for IV chemotherapy treatments.
- Prepared admixture for chemotherapy agents following physician instructions.
- Obtained authorizations from pharmacy benefit managers.
- Advocated for patients not insured or underinsured seeking assistance through foundations or pharmaceutical companies.
- Maintained and disseminated communication between physicians and patients regarding status of prescriptions.
- Reviewed and filled prescriptions in coordination with physicians to ensure patient safety and compliance.
- Executed operational tasks for successful opening of multiple facilities.
- Developed pharmacy protocols and guidelines.
- Ensured prescriptions met federal and state regulations to maintain quality and legality.
- Submitted monthly drug expenditure reports for all physicians.
- Researched and implemented Electronic Medical Record System.
- Developed employee handbook and HIPAA Guidelines.
- Munster, IN 46321
Certified Pharmacy Technician
Cancer Health Treatment Centers
01.1995 - 10.2003
- Prepared chemotherapy admixture under physician supervision, ensuring compliance with safety standards.
- Tracked inventory and placed orders while negotiating contract pricing, optimizing supply chain management.
- Verified insurance benefits to facilitate patient access to necessary medications.
- Merrillville/Munster, IN
Education
Prior Authorization Certified Specialist -
NATIONAL BOARD OF PRIOR AUTHORIZATION SPECIALIST
01-2025
Oncology Patient Navigator Certification -
GEORGE WASHINGTON UNIVERSITY CANCER CENTER
01-2023
Bachelor of Science - Network and Telecommunications Management
Devry University
10-2004
Pharmacy Technician -
Indiana Professional Licensing agency
01-2002
National Pharmacy Technician Certification -
National Pharmacy Technician Certification board
01-1995
Skills
- Operational and managerial duties
- Detail orientation
- Results focus
- Organizational skills
- Relationship building
- Conflict resolution
- Territory management
- Account management
- Project management
- Billing and reimbursement
- Collaboration skills
- Exceptional communication and interpersonal skills
- Pharmacological terminology proficiency
- ICD-10 coding expertise
Certification
- • Oncology Patient Navigator Certification – George Washington University Cancer Center (2023)
• Prior Authorization Certified Specialist (PACS) – National Board of Prior Authorization Specialist (2025)
• Bachelor of Science, Network and Telecommunications Management – DeVry University (2004)
• Registered Pharmacy Technician – Indiana Professional Licensing Agency (2002)
• Certified Pharmacy Technician (CPhT) – Pharmacy Technician Certification Board (1995)
Timeline
Field Reimbursement Manager
Johnson & Johnson
04.2024 - Current
Field Access and Reimbursement Manager
Cencora/Xcenda, LLC
05.2018 - 04.2024
Adjunct Instructor - Pharmacy Technician Course
Brightwood College
02.2018 - 05.2018
Specialty Pharmacy Manager/ Practice Manager /Authorization & Benefits Manager /IV Technician
Northwest Oncology, PC
10.2003 - 12.2017
Certified Pharmacy Technician
Cancer Health Treatment Centers
01.1995 - 10.2003
Prior Authorization Certified Specialist -
NATIONAL BOARD OF PRIOR AUTHORIZATION SPECIALIST
Oncology Patient Navigator Certification -
GEORGE WASHINGTON UNIVERSITY CANCER CENTER
Bachelor of Science - Network and Telecommunications Management
Devry University
Pharmacy Technician -
Indiana Professional Licensing agency
National Pharmacy Technician Certification -
National Pharmacy Technician Certification board