Lisa Bias
Carrollton,Tx
Summary
Good communication and interpersonal skills. Ability to perform tasks in a detail-oriented manner. Over 7 years of customer service/Pro-Pbm experience. Adaptable and ability to work under pressure. Attention to detail, quick study, self-motivated. Ability to assume multiple responsibilities and remain productive in a time-sensitive, fast-paced work environment. Proficient leader, address needs with employees and motivate them to perform at their best. Time management. Process improvement experience. Experienced in creating and delivering training. Benefits Specialist dedicated to assisting employees with open enrollment for smooth and simple process. Offering more than 7 years of documenting and reporting changes in relation to benefits. Composed, talented, and effective team player. Collaborative individual with expertise in providing exemplary service regarding benefits support. Multitasking Benefits Specialist knowledgeable in state and federal regulations and maintaining employee confidentiality. Self-motivated Benefits Specialist demonstrating superior understanding of employee benefits laws and human resource software systems. Astute professional providing benefits support in fast-paced corporate settings. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level. Ready to help team achieve company goals.
Overview
23
23
years of professional experience
Work History
Case Manager
Amgen, Cardinal Health/Sonexus Health
05.2022 - Current
- Followed through on all critical inter-departmental escalations to increase customer retention rates
- Responded to customer calls and emails to answer questions escalations
- Responded proactively and positively to rapid change
- Promptly responded to inquiries and requests from prospective customers
- Managed pharmacy benefits on behalf of contracted insurance companies by addressing pharmacy benefits, claim submittal procedures, and claim statuses
- Verified Insurance Benefits and Authorizations outbound calls to all major insurance companies Medicare Medicaid both private and government insurance.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
Benefits Verification Specialist
Amgen, Cardinal Health/Sonexus Health
09.2021 - 05.2022
- Verify eligibility and benefits on all patient referrals
- Collected and reviewed all patient insurance information needed to complete benefit verification
- Obtain specific benefits for various payer plans that include patient coverage and cost share
- Entered benefit data for patients accurately into Pulse System
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
- Demonstrated respect, friendliness, and willingness to help wherever needed
- Offered friendly and efficient service to customers, handled challenging situations with ease.
Care Coordinator
Xelsource, Cardinal Health/Sonexus Health
04.2021 - 09.2021
- Received inbound calls from patients, doctor offices, pharmacies
- Reported all Adverse Events related to drug therapy and pharmacy care
- Provided update enrollment information to patients and doctor offices
- Provided Support for Case Managers to patients regarding enrollment
- Activated and provided copay card for qualified patients
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction
- Adhered to company policies and scripts to consistently achieve call-time and quality standards
- Enhanced productivity by staying on top of call scripts and maintaining control over direction of conversations
- Verified accurate responses to questions and inquiries by maintaining advanced product knowledge.
Care Coordinator
Pfizer/Eucrisa, Cardinal Health/Sonexus Health
04.2020 - 06.2020
- Answers incoming calls from new and existing patients and doctor offices
- Report all Adverse Events related to therapy
- Investigate and resolve patient and physicians' inquiries
- Adhered to company policies and scripts to consistently achieve call-time and quality standards
- Maintained accurate and current customer account data with manual forms processing and digital information updates
- Investigated and resolved customer inquiries and complaints quickly
- Met customer call guidelines for service levels, handle time and productivity
- Responded proactively and positively to rapid change
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
Senior Care Coordinator
Astra Zeneca, Cardinal Health/Sonexus Health
09.2019 - 06.2020
- Received inbound and outbound calls from patients, HCP offices, pharmacies and manufacturer
- Actively worked with different insurance companies and HCP office on completing benefits investigations, prior authorizations and appeals
- Developed and maintained professional relationships with internal and external clients
- Knowledgeable of Medicare, Medicaid, and Commercial Insurance Plans
- Prioritize daily tasks and resolved patients/HCP offices concerns
- Answered customer telephone calls promptly to avoid on-hold wait times
- Responded to customer requests, offering excellent support and tailored recommendations to address needs
- Exhibited high energy and professionalism when dealing with clients and staff.
340B Product Analyst
McKesson/Macro Helix
10.2018 - 08.2019
- Responded promptly and accurately to incoming customer inquiries, escalating if needed to appropriate resource(s)
- Provided continuous updates to customers on open items, ensuring proper follow up and steps to close cases take place
- Resolved and researched customers issues related to ordering and 340B pricing and contract
- Handled advanced/critical/sensitive issues that could result in loss of revenue
- Performed streamlined, simplified installation for change of entity requests
- Responsible for handling bundled cases which results in higher rate of customer satisfaction
- Followed up with customers on unresolved issues.
Call Center Pharmacy Technician
Millton Solutions/Medoc
03.2018 - 08.2018
- Answer inbound calls promptly and professionally
- Retrieved new patients from the Intake queue
- Investigate patient insurance benefits and other supplemental payer information
- Answer and reply to call experts messages, escalate to proper team if needed
- Assist in queue calling
- Review claim reimbursement and resolve any resolve any rejections from third party plans
- Assist patients with copay assistance programs or payment plans
- Superior time management skills to be able to manage multiple priorities and meet deadlines.
Lead Help Desk Specialist
Hospice Pharmacy Solutions/Care Services
02.2017 - 02.2018
- Managed workflow of all client requests through faxes and calls to ensure all calls and faxes are answered and processed in a timely manner
- Collect, troubleshoot, and verify accuracy of data such as patient demographics, medication, names, strength, quantities, etc
- From direct contact, calls, faxes, emails for input into claim processing system
- Initiated and maintained a good rapport with internal and external clients
- Research external client complaints and complete needs within 24 hours
- Engage and perform in coaching and development of Help Desk Specialist as needed
- Prioritize and organize assigned work and assume responsibility for special projects, assignments, and other related duties as required or assigned
- Complete weekly census reports
- Develop training materials and best practices tips to improve quality and efficiency
- Followed up with clients to verify optimal customer satisfaction following support engagement and problem resolution
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
- Carried out day-day-day duties accurately and efficiently
- Demonstrated respect, friendliness, and willingness to help wherever needed.
Lead Patient Care Coordinator
Amerisource Bergen/Us Bioservices
06.2013 - 02.2017
- Deliver coaching feedback to agents
- Resolved and handled customer services related issues and complaints
- Monitored all calls to ensure that due procedures and quality standards are strictly adhered to
- Submitted regular reports to management and seek new ideas and strategies to improve performance
- Ensured that clients are always kept happy and satisfied by providing prompt response and solutions to their challenges at all time
- Ensured a safe and harmonious working environment for all other team members and delegate duties to all team members.
Patient Care Coordinator
Amerisource/US Bioservices
08.2011 - 05.2013
- Maintains information and assists in the record keeping related to clinical trials required by the study protocols
- Work closely with Pharmacy Care Representatives in providing excellent patient care
- Received inbound and outbound calls from patients and providers in a timely manner
- Contact patients to schedule their refills
- Use a courteous and professional customer-focused approach while interacting with customer over the phone
- Perform other related duties as assigned prior authorization coordinator
- Completed administrative patient intakes with case histories, insurance information and mandated forms
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
Prior Authorization Specialist
DAVITA RX
07.2011 - 06.2012
- Reviewed requests made by physicians and pharmacies for use of prescription drugs that are non-formulary, have prior authorization requirements, have exceeded quantity or cost limits, or require assistance in on-line processing of a prescription claim
- Accurately processed, entered, and documented all submitted prior authorization requests in accordance with Medi-Cal and Medicare policies
- Displayed patient-oriented and comprehensive clinical pharmacy services and pharmaceutical care
- Effectively prioritized tasks and organized workflow to increase efficiency
- Contacted insurance companies as required to obtain Therapeutic Interchange or Prior Authorization
- Research and resolve prescriptions adjudication rejections to ensure patient receive their medication in a timely manner
- Maintained accurate and current information on spreadsheet for tracking purpose
- Contacted patients as necessary regarding delays in receiving their medications due to prior authorization needed
- Met or exceeded service and quality standards every review period
- Reached out to insurance carriers to obtain prior authorization for testing and procedures
- Inputted all patient data regarding claims and prior authorizations into system accurately
- Researched denied claims and contacted insurance companies to resolve these issues.
Clinical Pharmacy Technician
Express Scripts/Wellpoint
01.2002 - 04.2010
- Sought and responded to needs and expectations of internal and external clients by researching and analyzing data
- Facilitated resolutions of drug coverage issues and pro-actively addressed and researched issues
- Provided price quotes, order status, insurance verification
- Notified physician's office of the outcome of their prior authorizations
- Acted professionally and patiently when addressing negative customer feedback
- Entered new authorizations cases and rendered coverage determination based on clinical criteria and plan design
- Made accurate, timely and consistent coverage determinations for patients
- Verified eligibility and compliance with authorization requirements for service providers.
Pharmacy Technician
Tom Thumb Pharmacy
01.2002 - 12.2006
- Entered new prescriptions into computer system
- Maintained and conducted inventory control
- Contacted physicians' offices by phone or fax regarding refills
- Assisted pharmacist in counting medications
- Answered incoming phone calls and addressed questions from customers and healthcare providers
- Counted and labeled prescriptions with correct item and quantity
- Stocked, labeled, and inventoried medication to keep accurate records
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists
- Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality
- Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
Education
Certified Pharmacy Technician -
North Texas Professional Institute
Dallas, TX05.2003
Bachelor of Science -
Grambling State University
Grambling, LA05.2001
Diploma -
Jennings High School
Jennings, LA05.1995
Skills
- Eligibility Determinations
- Technological Knowledge
- Service Delivery
- Conflict Resolution
- Compassionate Care
- Managing Patient Cases
- Prescription Refill Fulfillment
- Prescription Order Verification
- Answering and Routing Calls
- Patient Profile Setup
- Medication Documentation
- Ordering and Stocking Medications
- Insurance Claim Processing Software
- Confidentiality and HIPAA
- Problem-Solving
- Case Documentation
- Organization and Multitasking
- Documentation And Reporting
- Decision-Making
- Email and Telephone Etiquette
- Care Coordination
- Documentation proficiency
- Patient support
- Time Management
- Active Listening
- Attention to Detail
- Client meetings
Timeline
Case Manager
Amgen, Cardinal Health/Sonexus Health
05.2022 - Current
Benefits Verification Specialist
Amgen, Cardinal Health/Sonexus Health
09.2021 - 05.2022
Care Coordinator
Xelsource, Cardinal Health/Sonexus Health
04.2021 - 09.2021
Care Coordinator
Pfizer/Eucrisa, Cardinal Health/Sonexus Health
04.2020 - 06.2020
Senior Care Coordinator
Astra Zeneca, Cardinal Health/Sonexus Health
09.2019 - 06.2020
340B Product Analyst
McKesson/Macro Helix
10.2018 - 08.2019
Call Center Pharmacy Technician
Millton Solutions/Medoc
03.2018 - 08.2018
Lead Help Desk Specialist
Hospice Pharmacy Solutions/Care Services
02.2017 - 02.2018
Lead Patient Care Coordinator
Amerisource Bergen/Us Bioservices
06.2013 - 02.2017
Patient Care Coordinator
Amerisource/US Bioservices
08.2011 - 05.2013
Prior Authorization Specialist
DAVITA RX
07.2011 - 06.2012
Clinical Pharmacy Technician
Express Scripts/Wellpoint
01.2002 - 04.2010
Pharmacy Technician
Tom Thumb Pharmacy
01.2002 - 12.2006
Certified Pharmacy Technician -
North Texas Professional Institute
Bachelor of Science -
Grambling State University
Diploma -
Jennings High School
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