Karesha McClure

Review and ensure all incoming forms are complete and legible

• Follow up with stakeholders as appropriate to collect and capture missing/incomplete/illegible information
• Accurately capture program specific requirements from referral into Program Software Platform
• Ensure timely processing of all forms/referrals based on pre-set program requirements
• Create new patient profiles or accurately associate correspondence to existing patient profile
• Assess request on forms and associate appropriate services/resources based on business rules and program guidelines
• Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events)
• Answer and triage inbound calls to assigned case managers or appropriate partners (Program Specific)
• Triage referrals and task assigned case managers regarding the appropriate next steps (Program Specific)
• Work closely with internal team to appropriately manage and resolve issues (Program Specific)
• Maintain confidentiality of patient and proprietary information (Program Specific)

• Maintained confidentiality and integrity of patient data.
• Verified technical reimbursement questions for providers, billing and coding staff.
• Coded patient care records to provide accurate information for billing.
• Determined medical necessity, using individual insurance carrier regulations.
• Researched rejections, investigating problems to appeal claims.

• Input client information into spreadsheets and company database to provide leaders with quick access to essential client data.
• Identified and corrected data entry errors to prevent duplication across systems.
• Reviewed and updated account information in company computer system.
• Obtained scanned records and uploaded into company databases.

• Collected and processed specimens in medical environment.
• Completed administrative support work to maximize laboratory efficiency.
• Sanitized workstations and instruments to avoid cross-contamination.
• Created detailed reports summarizing data collected in laboratory for research and development, regulatory affairs and marketing teams.
• Performed various administrative duties, including data entry and document preparation.

• Documented patient intake and dietary requirements, also assisting with feeding and monitoring.
• Conducted routine checks on standard patient vitals, including blood pressure, blood sugar and heart rate.
• Promoted patient satisfaction by assisting with daily living needs such as bathing, dressing, toileting and exercising.
• Engaged with patient family and friends to provide courteous, efficient visit experience.

• Maintained daily inventory of pharmaceuticals and ensured proper storage conditions.
• Prepared medications for dispensing by counting, pouring, labeling, and verifying doses.
• Managed filing of prescriptions, both electronically and manually.
• Retrieved medication from shelves based on physician orders and delivered them to pharmacists for review.
• Verified accuracy of medication labels before they were dispensed to customers.
• Ensured compliance with all federal, state, local laws and company policies related to pharmacy operations.
• Checked expiration dates on medications to ensure that only unexpired products were dispensed.
• Reported any discrepancies or errors in medication ordering or filling processes immediately to the pharmacist on duty.
• Restocked shelves with new supplies of medications as needed.
• Kept accurate records of controlled substances received and dispensed in accordance with DEA regulations.
• Organized work areas so that everything was easily accessible when needed.
• Assisted in training new employees on pharmacy procedures.
• Monitored inventory levels of commonly used drugs and placed orders when necessary.
• Teamed with peers, technicians and pharmacists to prioritize and complete orders.
• Refilled medications, offered insight into over-the-counter products and verified insurance benefits.
• Verified prescriptions and drug labels, documents and packages.