Top-performing, experienced Biologic Coordinator and Sales Associate, with a proven record of achievement and success in driving exponential growth in bio-pharmaceutical sector. Specialized in working with commercial and government payer reimbursement, health reimbursement law, claim denial management, and patient access to bio-pharmaceuticals on the market. One who excels in the development and maintenance of complex, client-driven reimbursement programs in highly competitive markets.
Overview
6
6
years of professional experience
Work History
Biologic Coordinator/Lead Sales Associate
Southwestern Dermatology
Oklahoma City, United States
08.2023 - Current
Advise and assist healthcare entities in overcoming payer access and reimbursement issues in order to maximize patient access to FDA-approved pharmaceuticals.
Educate providers on product fulfillment pathways, including physician buy and bill, retail pharmacy and specialty pharmacy options. Provide E-service training to providers requesting online access to benefit investigations, prior authorization support, specialty pharmacy research, and product information involving ICD-9, CPT and HCPCS coding.
Develop market access and pricing proposals to assist with negotiation of drug pricing.
Specialized reimbursement knowledge within the following disease states dermatology, rheumatology, and oncology.
Partner with reimbursement matrix team and third-party reimbursement support program to assist health care providers within the following: reimbursement and access copay assistance programs, prior authorization support, claims denial management and tracking, health benefit verification, and clinical policy education.
Experienced with insurance companies: Aetna, BCBS, Cigna, Humana, Medicaid, Medicare, Tricare, and UnitedHealthcare
Participated in ongoing training sessions to stay updated on the latest developments in the field of dermatology sales.
Implemented a systematic follow-up routine with clients to ensure long-term customer loyalty and retention, ultimately resulting in increased referrals and revenue growth.
Biologic Coordinator/Lead Medical Assistant/Sales Associate
Mercy Dermatology
Edmond
09.2020 - 07.2023
Implemented project management techniques to overcome obstacles and increase team productivity
Administrative duties include management of healthcare insurance clearance, clinic quality management, data sharing and connectivity, policy implementation and development, and health information management
Coordinate with medical providers and insurance carriers to secure coverage and navigate through authorization and appeals processes. Ensure prior authorization requests are processed efficiently and accurately, ultimately improving patient care and satisfaction. Facilitate beginning to end streamline processes for drug coverage through insurance, reimbursement programs, or co-pay assistance.
Participated in workshops and in-service meetings to enhance personal growth and professional development.
Branded products through effective salesmanship and maintained long-term relationships with clients.
Medical Assistant/Emergency Department Medical Scribe
Norman Regional Hospital
Norman
08.2018 - 12.2021
Oriented and trained new staff on proper procedures and policies.
Implemented care and efficiency improvements to support and enhance office operations.
Collaborated with interdisciplinary healthcare teams to provide coordinated care for patients in various settings.
Maintained strict adherence to infection control protocols by following proper sterilization techniques for medical equipment.
Independent duties include suture removals, urine pregnancy tests, butterfly blood draws, minor laser procedures, administration of IM&IL injections, centrifuge, KOH prep, and relaying test results to patients.
Assists physicians with e-scribing , manage and audit electronic health records
Education
Master of Legal Studies - Healthcare Law
University of Oklahoma
Norman, OK
09.2022
Bachelor of Science - Biochemistry
University of Oklahoma
Norman, OK
12.2018
Skills
Motivated self-starter
HIPAA regulations and compliance
Insurance billing
Strong presentation skills
Patient-focused reimbursement support
ICD-9/ICD-10 (International Classification of Disease Systems)
HCPCS and CPT coding guidelines
Familiar with commercial and managed care insurance carriers
Patient account reviews
Multitasking Abilities
Claims Management
Problem-solving abilities
Certifications
Prior Authorization Certified Specialist (PACS)
EMR-ER & EMR-DERM continued education
Medical Assistant Certification
Certificate of Biologics and Biosimilars Specialist Program
System Expertise
Microsoft Word, MS Excel, MS PowerPoint, Epic HER systems, Meditech EMR system, Audacity, EMA EMR system, Paycom, Workday, Nextech
Affiliations
Biologic Coordinators of Dermatology
Accreditation Council for Medical Affairs (ACMA)
Timeline
Biologic Coordinator/Lead Sales Associate
Southwestern Dermatology
08.2023 - Current
Biologic Coordinator/Lead Medical Assistant/Sales Associate
Mercy Dermatology
09.2020 - 07.2023
Medical Assistant/Emergency Department Medical Scribe