Najsha Simmons
Sullivans Pharmacy
Brockton,MA
5
years of professional experience
Work History
DME Intake Coordinator II
10 Months- Review, process and audit incoming clinical data received via prescriber emails, electronic faxes and direct system-to- system transfers against strict medical necessity guidelines.
- Create the majority of official sales orders within the centralized software system based on verified referral data and clinical documentation.
- Own and manage the entire prior authorization lifecycle, submitting clinical PDFs to insurance portals, tracking approved deadlines and executing standard appeals for technical denials.
- Maintain dedicated, proactive communication with high- volume referral accounts to ensure seamless patient transition and maintain account relationships.
- Contact patients directly to resolve order delays, discuss complex eligibility issues, or handle escalated issues unresolved from the coordinator 1 team.
- Same& similar Medicare certified
TSA Agent
8 Months- Completed FLETC training and became certified with a badge number.
- Enforced proper safety regulations while in the airport to keep the public and commerce safe.
- Check all ID and make sure the screening procedures are done correctly.
- Observe and thoroughly check luggage, passengers and the area for explosives and items that can be harmful to the flying public.
Order Intake Specialist
8 Months- Faxed out patient orders to different doctors and physicians.
- Attached all signed orders coming from doctors to patient portals.
- Meet with doctors to get order times and signed documentation for billing different insurances.
- Creating relationships with other case managers an doctors to promote and market our system.
Quality Assurance Managers
5 Months- Worked with clients out of facilities or their homes to make sure the quality of care from our company was being exceeded.
- filling in with patients when caregivers are unavailable.
- coached and trained employees
- logged all detailed and statements into company system to compliance deadlines.
Caregiver
2 Years 3 Months- Cleaned, meal-prepped, laundry, errands, appointment runs and planned daily activities.
- Created healthy relationships with with staff and patients to insure safety and a good experience with he company.
- Updated manager with progress on each patient i was assigned to.
Education
High School Diploma
- Awarded TRANSPORTATION SECURITY OFFICER BASIC TRAINING PROGRAM
Skills
Medicare Insurance Certified
Communication Skills
Multi-line phone systems
Appointment scheduling
Multitasking Ability
Timeline
DME Intake Coordinator II
Sullivans Pharmacy
10.2025 - CurrentRead More
TSA Agent
Homeland Security US Department
12.2024 - 08.2025Read More
Order Intake Specialist
Home First Home Healthcare
01.2024 - 09.2024Read More
Quality Assurance Managers
Senior Helpers
08.2023 - 01.2024Read More
Caregiver
Comprehensive Care
05.2021 - 08.2023Read More
Pace
High School Diploma
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