Kristin Pan

Summary

Resourceful and detail-oriented healthcare professional with experience in managing and resolving member complaints, particularly within Medicare programs. Skilled in handling issues related to prescription copays, medication coverage, and member education. Adept at multitasking, prioritizing responsibilities, and navigating administrative tasks such as managing paper claims and creating organized claim packets.

Overview

years of professional experience

Work History

Coordinator 1

Centene

Natomas, CA

03.2017 - Current

Medicare Programs:

Research and resolve issues using appropriate reference material
Operational issue resolution, including issues from Prior Auth, Appeals and Grievances, Member and Provider Services
Utilize Excel reviewing claim reports
ESRD and Hospice Reports
DARR (Detail Analysis Report Review)
Ember
Using CTE for testing scenarios to ensure that they pay or reject correctly for the new year

Paper Claims:

Pulled new paper claims from DPIR, CenPas, and through direct mail. These were printed and compiled a packet with a cover sheet
NEC's (Non- electric claims) provider claims
DMR's

Education

Pharmacy Technician -

Institute of Technology

Citrus Heights, CA

2012

High School Diploma -

John F. Kennedy

2003

Skills

Issue resolution (member's copay amounts, member education, trying to get a member's medication covered by the member's plan)
Multitasking and time management

Utilizing Excel for reports and report analysis

References

References available upon request.

Timeline