Michelle Bradford
Field Reimbursement Access Specialist
Oklahoma City,OK
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Able to maintain relationships with HCP offices and adjust travel as needed within the territory.
Overview
12
12
years of professional experience
Work History
Field Reimbursement Access Specialist
Cencora
05.2023 - Current
- Implemented process improvements to expedite patient flow, reducing bottlenecks and enhancing overall efficiency.
- Provided exceptional customer service while managing high call volumes, addressing inquiries quickly while maintaining professionalism at all times.
- Maintained strict confidentiality of sensitive patient data in compliance with HIPAA regulations, safeguarding personal information from unauthorized access or disclosure.
- Collaborated with interdisciplinary teams to ensure timely and appropriate patient care coordination.
- Assisted offices with navigating complex insurance plans, helping them maximize benefits and minimize out-of-pocket expenses for patients.
- Regularly met with biologic coordinators to determine their level of need for patient progress and assisted in ensuring patients were put within correct programs.
- Developed and maintained relationships with high volume writers and many other clinics within my territory.
- Managed my time efficiently to make ensure all offices within my territory we're taken care of in timely fashion.
Biologic Speaker
Eli Lilly Pharmaceuticals/Physicians World LLC
08.2017 - 05.2023
- Contributed to the growth of personal brand as a speaker by consistently exceeding client expectations and maintaining a high level of professionalism throughout all engagements.
- Continuously refined speaking skills through ongoing professional development opportunities such as workshops or coaching sessions.
- Expanded professional network through active participation in industry conferences, workshops, and seminars.
- Educated HCP offices on product specific access programs and patient assistance programs.
- Spoke efficiently to large audiences maintaining composer and poise.
- Educated HCP offices on prior authorization and appeal process to ensure patients started and stayed on therapy.
- Connected with attendees through empathetic listening and genuine responses during Q&A sessions.
- Inspired action within the audience by sharing personal experiences and lessons learned throughout career journey.
Biologics Coordinator/Back Office Lead Medical Assistant
Southwestern Dermatology
05.2014 - 05.2023
- Educated patients on available biologic treatments and therapies based on current diagnosis.
- Initiated all prior authorizations and appeals with diverse payers including Medicare and Medicaid.
- Understanding of pharmaceutical bridge programs and patient assistance programs.
- Assisted directly with patient care daily.
- Assisted directly with surgical procedures.
- Established flow for the clinic in how to efficiently room patients to provide timely management for providers.
- Worked closely with specialty pharmacies to ensure patients maintained therapy.
- Worked closely with pharmaceutical representatives and FRM's to ensure I was up to date with most recent indications and changes in formulary.
- Communicated reimbursement and access to providers and colleagues to help them understand current programs for all biologic medications.
Medical Billing Specialist
PhyCon
10.2012 - 04.2014
- Posted and adjusted payments from insurance companies.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
Education
High School Diploma -
U.S. Grant High School
Oklahoma City, OK 05.2001 -
Skills
CPT Knowledge
ICD-10 Proficiency
Denial Management
Bill payment
Payment posting
Medicare and Medicaid process
HIPAA Compliance
Customer Support
Expert Communication
Engaging Presence
Subject matter expertise
Relationship Management
Timeline
Field Reimbursement Access Specialist
Cencora
05.2023 - Current
Biologic Speaker
Eli Lilly Pharmaceuticals/Physicians World LLC
08.2017 - 05.2023
Biologics Coordinator/Back Office Lead Medical Assistant
Southwestern Dermatology
05.2014 - 05.2023
Medical Billing Specialist
PhyCon
10.2012 - 04.2014
High School Diploma -
U.S. Grant High School
05.2001 -