Linda Carrion
Oviedo,FL
Summary
Dedicated and detail-oriented Case Manager with extensive expertise in client advocacy, benefits investigations, and case management processes. Skilled in navigating complex insurance policies, resolving client challenges, and coordinating support services. Proven ability to optimize operations and enhance efficiency in fast-paced environments. Achieved a 98% accuracy rate in case documentation and reduced case processing time by 30% through workflow improvements. Passionate about delivering outstanding customer service and ensuring compliance with industry standards.
Overview
9
9
years of professional experience
Work History
Reimbursement Specialist
Hiregy (Contract)
Remote
12.2024 - 02.2025
- Verified patient insurance benefits to prevent coverage lapses during therapy
- Completed 35+ outbound calls and closed 20+ cases daily
- Confirmed policy details, checking active coverage, ensured providers have current information for proper reimbursement
- Additionally, verified network status, reimbursement rates, prior authorizations, and required documentation to avoid treatment interruptions
Case Manager
Cardinal Health
Remote
05.2023 - 06.2024
- Performed Benefit Investigations of Specialty Medications
- Contacted insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections
- Initiated Prior Authorization process when required
- Placed outbound call to patients to assess for eligibility for copay and financial assistance
- Verified forms and supporting documentation thoroughly for any missing information
- Updated cases with new information as needed
- Responsible for placing outbound calls to patients and physicians advising of case status and documents needed to complete enrollment
- Maintained accurate and detailed notations for every interaction
- Perform any additional tasks as assigned
Case Manager (Contract)
Randstad
Remote
08.2022 - 05.2023
- Responsible for the accurate review of applications for re-enrollment.
- Monitored system accounts for new patient cases
- Contacted insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections
- Initiated Prior Authorization process when required
- Placed outbound call to patients to assess for eligibility for copay and financial assistance
- Verified forms and supporting documentation thoroughly for any missing information
- Updated cases with new information as needed
- Responsible for placing outbound calls to patients and physicians advising of case status and documents needed to complete re-enrollment
- Maintained accurate and detailed notations for every interaction
- Perform any additional tasks as assigned
Insurance Verification Specialist
AllianceRx Walgreens/Prime
Orlando, FL
11.2015 - 12.2021
- Research and resolve issues regarding discrepancies with prescription claims processed
- Own problems with orders through to resolution working with patients, medical practitioners, and other internal groups to ensure that all patients receive their medications without delay
- Verify patient eligibility, determine patient coverage, coordinate benefits, process test claims, and initiate prior authorization process
Education
Undergraduate - Medical Records
University of Phoenix-Online Campus
High School Diploma -
University High School
06.1992
Skills
- HIPAA
- Account management
- Microsoft Excel
- Communication skills
- Customer Service Skills
- Outlook
- Microsoft Word
- Claims
- Time management
- ICD-10
- Medical Receptionist
- Healthcare Management
- Benefits administration
- 10 key typing
- Behavioral health
- Excel
- Phone etiquette
- Computer skills
- Writing skills
- Customer Service
- Microsoft Powerpoint
- Data Entry
- Medical Records
- Microsoft Office
- Scheduling
- Computer literacy
- Clerical experience
- EMR
- Insurance Verification
- Typing
- Windows
- Medical Collection
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Reimbursement Specialist
Hiregy (Contract)
12.2024 - 02.2025
Case Manager
Cardinal Health
05.2023 - 06.2024
Case Manager (Contract)
Randstad
08.2022 - 05.2023
Insurance Verification Specialist
AllianceRx Walgreens/Prime
11.2015 - 12.2021
High School Diploma -
University High School
Undergraduate - Medical Records
University of Phoenix-Online Campus