Summary
Overview
Work History
Education
Value Offered
Skill Sets - Computer Applications
Timeline
AdministrativeAssistant
Natasha McAfee

Natasha McAfee

Customer Service
Charlotte,NC

Summary

An organized, detail-oriented, and self-motivated professional with over 9+ years of experience in customer service within the healthcare industry. Areas of expertise include data & analytics, planning, evaluating, communicating and multi-tasking. A hard working, goal oriented, and flexible team player who produces quality work while maintaining production targets, achieves company objectives, and adapts well to a changing environment. Results-driven Consultant with comprehensive experience leading and improving industry operations. Uniquely qualified to navigate rigors of latest standards, specifications and protocols for organizational and regulatory needs fulfillment. Lends complex roadmaps and calls-to-action to regularly achieve ambitious objectives. Motivated individual with business acumen and willingness to take on challenging roles. Tech-savvy and quick learning with technical know-how, social media expertise and sales abilities to support and drive substantial growth.

Overview

9
9
years of professional experience

Work History

Patient Access Consultant

AmerisourceBergen
Charlotte, NC
05.2020 - Current
  • Master of all standard and advanced services within the healthcare industry which includes but not limited to: Billing & Coding Support, claims assistance, prior authorization support, determining what support programs patients qualify for
  • Engages with manufacturer representative to discuss payer profiles & reimbursement trends
  • Responsible for coordination of services working directly with field reimbursement teams
  • Providing excellent customer service to patients & providers by resolving issues in a timely manner, accurate reporting, & escalating complaints accordingly
  • Provides training & support to internal associates & temporary associates
  • Independently & effectively resolves complex accounts with minimal supervision
  • Maintains confidentiality in regard to all patient information
  • Work independently to determine methods & procedures on new or special assignments
  • Completed work instructions for new products / new systems.

Annual Reverification Support Specialist

Regeneron (Eylea) & Pfizer enCompass
10.2019 - 06.2021
  • Completed daily reports
  • Completed feedback trackers and forwarded to the staffing agencies
  • Completed weekly timesheets for up to 150 associates
  • Reported escalations to senior management and staffing agencies
  • Attended weekly meetings regarding production, attendance, etc
  • Submitted termination request to the senior management team
  • Completed peer mediation and conflict resolution amongst associates
  • Gave weekly and daily feedback to associates
  • Gave recommendations for associates for other opportunities within the company based on attendance, production, and quality performance
  • Reinforced training scenarios (Patient Plus, NPT, Blurb Tool, Fusion etc.) Kept account of daily attendance, late arrivals, and early departures
  • Provided daily updates on new processes and procedures
  • Drive program performance by establishing performance metrics
  • Analyze Quality Trends.

Annual Reverification Operations Manager

Regeneron (Eylea) & Pfizer enCompass
09.2018 - 02.2021
  • Completed daily reports
  • Completed feedback trackers and forwarded to the staffing agencies
  • Completed weekly timesheets for up to 150 associates
  • Reported escalations to senior management and staffing agencies
  • Attended weekly meetings regarding production, attendance, etc
  • Submitted termination request to the senior management team
  • Completed peer mediation and conflict resolution amongst associates
  • Gave weekly and daily feedback to associates
  • Gave recommendations for associates for other opportunities within the company based on attendance, production, and quality performance
  • Reinforced training scenarios (Patient Plus, NPT, Blurb Tool, Fusion etc.) Kept account of daily attendance, late arrivals, and early departures
  • Provided daily updates on new processes and procedures
  • Drive program performance by establishing performance metrics
  • Analyze Quality Trends.

Senior Reimbursement Counselor

AmerisourceBergen
Charlotte, NC
11.2016 - 11.2019
  • Collects and reviews all patient insurance benefit information
  • Performs related duties as assigned
  • Maintains frequent phone contact with provider representatives
  • Collects and reviews all patient insurance information needed
  • Understanding of payer eligibility and benefits
  • Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program
  • Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications
  • Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third-party payors
  • Researches and resolves any electronic claim denials
  • Researches and resolves any claim denials or underpayment of claims
  • Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods
  • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner
  • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers
  • Processes any necessary insurance/patient correspondence
  • Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation
  • Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims
  • Works on problems of moderate scope where analysis of data requires a review of a variety of factors
  • Exercises judgment within defined standard operating procedures to determine appropriate action
  • Typically receives little instruction on day-to-day work, general instructions on new assignments
  • Performs related duties as assigned
  • Provide training and support to internal associates.

Education

Medical Records Health Information Technology -

Southeastern Institute

Trained to become Licensed Instructor -

Superior Academy of Cosmetology

Universal College of Beauty

Value Offered

2019 PACE Graduate (Managerial Program), Capable of mentoring new employees considered a SME (subject matter expert) in all reimbursement, assisting with PRL’s, PSQA, Patient Plus & Fuison and the fax que., Extended knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding., Proficient at collecting and reviewing patient insurance information and benefits as it pertains to patient’s medical coverage., Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

Skill Sets - Computer Applications

  • Microsoft Outlook
  • Word
  • Excel
  • OneNote
  • PowerPoint
  • Salesforce

Timeline

Patient Access Consultant

AmerisourceBergen
05.2020 - Current

Annual Reverification Support Specialist

Regeneron (Eylea) & Pfizer enCompass
10.2019 - 06.2021

Annual Reverification Operations Manager

Regeneron (Eylea) & Pfizer enCompass
09.2018 - 02.2021

Senior Reimbursement Counselor

AmerisourceBergen
11.2016 - 11.2019

Medical Records Health Information Technology -

Southeastern Institute

Trained to become Licensed Instructor -

Superior Academy of Cosmetology

Universal College of Beauty
Natasha McAfeeCustomer Service