Mervyn Avila
Hialeah,Fl
Summary
Professionally trained Pharmacy Technician, Medical coding and billing with Manager Experience ensuring high standards of culturally competent care for wide variety of patients with diverse needs. Results-driven Regional Supervisor known for highly productive and efficient task completion. Specialize in strategic planning, team leadership, and operational management. Excel in communication, problem-solving, and adaptability, ensuring seamless operations across multiple locations. Committed to driving growth and achieving goals through effective supervision and mentorship.
Overview
32
32
years of professional experience
1
1
Certification
Work History
Admission Regional Supervisor
Coram/CVS Infusion Pharmacy
Jacksonville, USA
01.2024 - Current
- Process new IV referrals, verification of benefits, obtain authorization, create all Medicare forms for patient, Handle Sales team phone calls, Handle all complaints for the Admissions team, Monitor phone calls, schedule all the on-call personal, manage ADP for employees, create authorization for medication on non-formulary, ensured HIPPA compliance
- Managed all billing reports: work with billing on Denials from insurances, process all letter of agreements for payments
- Work on authorizations for drugs not cover by insurance companies
- EPIC System
- HCN Pharmacy System
- Salesforce
Senior Unbilled Team Representative
Coram/CVS Health
03.2023 - 01.2024
- Unbilled reports: MIR, UTP, Tickets confirmation and Billing Denial
- Working on report confirming Tickets and making sure the right documentation is on file to be able to bill
- Work on denials given by our billing department on Refills too soon, Dx Codes, missing Clinical documentations
- Making sure we have Coram Physician order sign to be able to bill our Medicare patients
- Trained on Epic system
- Work with Supervisor on getting all our billing reports on low Percentage to meet our goals
Admission Regional Supervisor
Coram/CVS Infusion Pharmacy
10.2012 - 07.2022
- Supervisor Admissions team of 22 Admissions staff
- Process new IV referrals, verification of benefits, obtain authorization, create all Medicare forms for patient, Handle Sales team phone calls, Handle all complaints for the Admissions team, Monitor phone calls, schedule all the on-call personal, manage ADP for employees, create authorization for medication on non-formulary, ensured HIPPA compliance
- Managed all billing reports: work with billing on Denials from insurances, process all letter of agreements for payments
- Work on authorizations for drugs not cover by insurance companies
Admission Manager
Univita/Allmed services of Florida
Miami Lakes, USA
01.2010 - 10.2012
- Managed team of 10 of professionals
- Managed Intake department, Obtain new referrals for Infusion services, obtain authorizations from insurance company, test bill all medications on patient's insurance company and Dispense correct doses and amounts
- Authorized drug refills and provided detailed prescription information to pharmacist
- Multi-tasked general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients
- Demonstrated ability to lead and motivate outstanding healthcare teams
- Contributed substantially to successful department JCAHO accreditation
- Ensured HIPAA compliance
Admission Supervisor
Walgreens/ Optioncare
Miramar, USA
01.2003 - 01.2010
- Intake supervisor
- Managed intake department
- Obtain new Infusion orders for home services, skilled nursing facilities, Doctors office, and ambulatory suites
- Obtain authorizations from insurance companies
- Obtain clinical information on patients to qualify patient for correct treatment
- Staff cases with nursing agencies
- Obtain correct orders from physicians to provide to pharmacist to dispense
- Train all new staff
- Assist billing department with any authorization issues
- Assist sales coordinators on in-services at insurance companies, doctor’s office, hospital case managers, etc
Pharmacy Intake Coordinator
Lifecare Solutions
Miami, USA
12.1998 - 12.2003
- Intake Coordinator
- Obtain new orders for Home infusion medications, DME and nursing
- Customer services, answering phones
- Data Entry, Insurance verification and Obtain authorization from Insurance
Intake Coordinator
Diversified Underwriters
Miami, USA
02.1997 - 11.1998
- Obtain New orders for Life Insurance company; Data Entry, Obtain Medical record, Qualify patients for an Insurance quote
- Customer Services, Answering multiple phone lines
- Filing
Customer Services
All-med services of Florida
Hialeah, USA
02.1993 - 01.1997
- Started in this company as a part time Filing clerk, after one year of working, I was trained on Customer services for Medical equipment
- I was entering patient in system, meeting criteria for patient to qualify for medical Equipment, Taking orders from doctors and hospital and dispensing equipments to patients home
- Obtain lots experience on the Medical field
Education
Medical Coding Billing -
Keiser Medical college
Tamarac, Florida01.2007
High school Diploma -
Hialeah High School
Hialeah, Florida01.1994
Pharmacy Technician - Medical Coding and Billing
Miami Dade Community college
Miami, FloridaSkills
- Clinical experience
- Healthcare billing
- Intravenous therapy
- Bilingual (Spanish)
- Problem resolution
- Phone communication
- Prioritizing/managing deadlines
- Organizational skills
- Patient-focused care
- IV drug therapy management
- ICD 10
- Medical coding
- Epic System
- Customer service
- Task Delegation
- Training and mentoring
- Operations Management
- Staff Management
- Processes and procedures
Certification
- Pharmacy Technician Florida license
- Medical Coding and Billing
Languages
English
Professional
Spanish
Professional
References
References available upon request.
Timeline
Admission Regional Supervisor
Coram/CVS Infusion Pharmacy
01.2024 - Current
Senior Unbilled Team Representative
Coram/CVS Health
03.2023 - 01.2024
Admission Regional Supervisor
Coram/CVS Infusion Pharmacy
10.2012 - 07.2022
Admission Manager
Univita/Allmed services of Florida
01.2010 - 10.2012
Admission Supervisor
Walgreens/ Optioncare
01.2003 - 01.2010
Pharmacy Intake Coordinator
Lifecare Solutions
12.1998 - 12.2003
Intake Coordinator
Diversified Underwriters
02.1997 - 11.1998
Customer Services
All-med services of Florida
02.1993 - 01.1997
- Pharmacy Technician Florida license
- Medical Coding and Billing
Medical Coding Billing -
Keiser Medical college
High school Diploma -
Hialeah High School
Pharmacy Technician - Medical Coding and Billing
Miami Dade Community college
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