Darleine Sajous
Murfreesboro,TN
Summary
Dedicated healthcare professional with extensive experience in patient registration, insurance verification, and managing patient inquiries. Demonstrates a proven ability to enhance patient satisfaction through effective communication and compassionate service, ensuring seamless interactions while adhering to healthcare protocols. Strong problem-solving skills combined with a commitment to continuous learning and teamwork make a valuable asset in achieving organizational objectives. Eager to embrace new challenges and contribute positively to team success with enthusiasm and dedication.
Overview
13
13
years of professional experience
Work History
Patient access specialist
AssistRx
Orlando, FL
12.2022 - 01.2025
- Secured prior authorizations by initiating requests, following up with necessary information, and expediting responses from insurance carriers and payers.
- Conducted thorough assessment of medication inventory to ensure accuracy.
- Ensured patients were aware of co-pay requirements and past due charges.
- Handled credit card payment processing efficiently.
- Schedule delivery of medication after all patient needs are addressed
- Recorded communications with pharmacy staff, patients, doctors, nursing agencies and related individuals.
Patient Care Coordinator
CVS Specialty Pharmacy
Orlando, FL
01.2017 - 12.2022
- Assist patients on Specialty prescription medications understand their benefits and financial responsibilities through superior customer service, while guaranteeing compliance with regulatory requirements.
- Obtain prior authorizations; initiate requests, follow up to provide required information, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed. Review for accuracy of prescribed treatment regimen prior to submission of authorization.
- Ascertain from the patient all of their supply needs and review medication
- Maintain statements and inform patients of co-pay xxxs and past due amounts
- Process payments in the form of credit card transactions
- Schedule delivery of medication after all patient needs are addressed
- Document all related communications with pharmacy personnel, patients, physicians, nursing agencies and other related individuals.
Customer Service Representative
UnitedHealth Group
Orlando, FL
06.2015 - 02.2017
- Answered calls from customers with issues related to benefit eligibility and prescription status
- Guided and educated customers on prescription benefits, use of plan, formulary, premiums and status of orders, and claims or inquiries
- Asked questions and listened to identify any issues while documenting information into the system
- Escalated drug related calls to licensed pharmacist for resolution
- Coordinated internal resolution of claims exceptions and other issues
- Assisted with entering new prescription orders into system
Customer Service Representative
Walt Disney World
Orlando, FL
02.2012 - 05.2015
- Provide superior customer service
- Informed guests about facilities, entertainment options, and rules and regulations
- Recorded details of attendance, sales, receipts, reservations, and repair activities
- Sold tickets and collected fees from customers
- Kept informed of shut-down and emergency evacuation procedures
- Completed all other projects and tasks as assigned
Education
Associate of Science Degree - Medical office administrator
SOUTHERN TECHNICAL COLLEGE
Orlando, FLAssociate of Science degree - Medical Assistant
SOUTHERN TECHNICAL COLLEGE
Orlando, FL01.2016
High School Diploma -
Freedom High School
Orlando, FL06.2011
Skills
- Medical Terminology
- Medical Ethics and Confidentiality
- Describing Prescriptions
- Patient Education
- Coding Charts Interpretation
- Trilingual (English, Haitian Creole, and French)
- 5 years of Salesforce experience
- Professionalism and ethics
- Appointment scheduling
- HIPAA compliance
- Front desk operations
- Medical terminology
- Exceptional communication
- Insurance billing
- Documentation accuracy
- Patient scheduling
- Performance standards compliance
- Fee collection
- EMR
- Medical terminology expertise
- Data entry proficiency
- Insurance verification
- Health information obtainment
- Patient interviewing
- Specialist referrals
- Eligibility determination
- Formularies
- Healthcare software
- Insurance information collection
- Authorization verification
- Healthcare reimbursements
- Co-payment collection
- Customer service
- Problem-solving
- Phone and email etiquette
- Multitasking and organization
- Conflict resolution
- Call screening
- Money handling
- Patient check-in
- Team leadership
- Medical billing
- Referral coordination
- Customer follow-up
- Friendly and outgoing
- Verbal and written communication
- Data entry
- Policy understanding
- Medical coding
- Insurance company billing
- Calm and effective under pressure
- Insurance verifying
- Administrative and office support
- Reliability and dedication
- Communicating to patients and families
- Caring and empathetic
- 50 WPM typing speed
- Clerical and filing support
- Benefits explanation
- Claims handling and coverage verification
- Insurance authorizations
- Punctual
- Medical insurance
Timeline
Patient access specialist
AssistRx
12.2022 - 01.2025
Patient Care Coordinator
CVS Specialty Pharmacy
01.2017 - 12.2022
Customer Service Representative
UnitedHealth Group
06.2015 - 02.2017
Customer Service Representative
Walt Disney World
02.2012 - 05.2015
Associate of Science Degree - Medical office administrator
SOUTHERN TECHNICAL COLLEGE
Associate of Science degree - Medical Assistant
SOUTHERN TECHNICAL COLLEGE
High School Diploma -
Freedom High School