Nathan Gerth
Pittsburgh,PA
Summary
Compassionate and forward-thinking with over 10 years experience in medical administrative roles. Well-versed in the complexities of patient care and able to navigate the change healthcare and insurance landscapes.
Overview
12
12
years of professional experience
Work History
Intake Specialist
ZOLL Medical Corporation
Pittsburgh, PA
05.2022 - 11.2022
- Inspected LifeVest durable medical equipment orders to confirm correct signatures and information.
- Investigated insurance policies to determine claim eligibility.
- Initiated prior authorizations with insurance companies in accordance to instructions.
- Updated patient information on computer system to maintain billing accuracy.
Benefit Verification Specialist
CVS Specialty Pharmacy
Pittsburgh, PA
11.2018 - 05.2022
- Verified and investigated patients' prescription and major medical insurance coverage for autoimmune prescriptions.
- Obtained missing clinical information from providers.
- Initiated prior authorizations with insurance companies.
- Processed drug claims in real-time adjudication.
- Explained insurance coverage to patients and providers.
- Registered eligible patients for copay and financial assistance programs.
- Fielded clinical questions to licensed pharmacists.
- Updated patient, provider and insurance information in systems to ensure billing accuracy.
Benefit Verification Specialist
Careform
Pittsburgh, PA
11.2016 - 11.2018
- Verified major medical health insurance benefits for Thyrogen orders.
- Provided relevant prior authorization forms to providers.
- Triaged prescriptions to specialty pharmacies.
- Determined financial assistance eligibility for patients.
Client Relations Specialist- Contract
Healthgrades
Madison, WI
06.2016 - 10.2016
- Answered inbound calls and registered patients with dozens of hospitals.
- Referred patients and caregivers to the appropriate providers based upon health needs and specialties, insurance coverage, and personal preferences.
Intern for Nursing Services Education Department
Meriter UnityPoint Health
Madison, WI
01.2016 - 05.2016
- Created applicable spreadsheets and collated patient and employee survey data.
- Printed, photocopied, faxed, and laminated documents for Nursing Services Education Dept.
- Proofread and edited internal and external written communications.
Customer Service Representative II- Contract
Exact Sciences Laboratories
Madison, WI
10.2015 - 01.2016
- Entered and updated patient and insurance information for prescription-only product Cologuard.
- Educated patients on the general prevention, testing, and treatment of colon cancer.
- Answered inbound calls, chats and emails to facilitate customer service.
Captionist and Coach
Captel Inc
Madison, WI
11.2010 - 11.2014
- Transcribed verbatim live individual and conference calls, as well as audio recordings onto a computer through voice recognition and typing.
- Maintained confidentiality and complied with company policies and federal regulations regarding client privacy.
- Promoted to Coach position in 2014 and provided training assistance, professional guidance, encouragement, and motivation to both new hires and existing coworkers.
- Educating and informed coworkers of changing rules, policies, and techniques to foster employee growth.
Education
Medical Billing And Coding
Community College of Allegheny County
Pittsburgh, PA04.2024
Associates of Applied Science (AS) - Medical Administration
Madison College
Madison, WI05.2016
Bachelor of Arts (BA) - Political Science, Minor in Sociology
University of Missouri
Columbia, MO05.2008
High School Diploma -
St. Paul Lutheran High School
Concordia, MO05.2004
Skills
- Medical Terminology
- Electronic Medical Record Software
- Insurance Coverage Verification
- Microsoft Office
- Strong Verbal and Written Communication
- Problem-Solving
- HIPAA Compliance
- Recordkeeping and Documentation
- Data Entry
- Claims Information Gathering
- Regulatory Requirements
Timeline
Intake Specialist
ZOLL Medical Corporation
05.2022 - 11.2022
Benefit Verification Specialist
CVS Specialty Pharmacy
11.2018 - 05.2022
Benefit Verification Specialist
Careform
11.2016 - 11.2018
Client Relations Specialist- Contract
Healthgrades
06.2016 - 10.2016
Intern for Nursing Services Education Department
Meriter UnityPoint Health
01.2016 - 05.2016
Customer Service Representative II- Contract
Exact Sciences Laboratories
10.2015 - 01.2016
Captionist and Coach
Captel Inc
11.2010 - 11.2014
Medical Billing And Coding
Community College of Allegheny County
Associates of Applied Science (AS) - Medical Administration
Madison College
Bachelor of Arts (BA) - Political Science, Minor in Sociology
University of Missouri
High School Diploma -
St. Paul Lutheran High School
Similar Profiles
Kate ReuschKate Reusch
Order Management Supervisor at ZOLL Medical CorporationOrder Management Supervisor at ZOLL Medical Corporation
Renee MorganRenee Morgan
Pateint Service Representative at ZOLL Medical CorporationPateint Service Representative at ZOLL Medical Corporation
Taishjelle KelleyTaishjelle Kelley
Assembly Line Worker at ZOLL Medical CorporationAssembly Line Worker at ZOLL Medical Corporation
Karlene MohanKarlene Mohan
Patient Service Representative at Zoll Medical Corporation. Brevard County.Patient Service Representative at Zoll Medical Corporation. Brevard County.
Catazja HendersonCatazja Henderson
Patient Care Technician at Allegheny General HospitalPatient Care Technician at Allegheny General Hospital