Autumn Paris

• Answer phone calls, provided information about treatments and procedures.
• Scheduled appointments and procedures.
• Administrative duties such as scanning, filing, faxing etc...
• Verified health insurance benefits, received payments.
• Maintained and updated patient records.
• Medical Assist duties as needed.

• Performed benefit verification of all patient insurance plan.

Responsible to document information related to coinsurance, co-pay, deductibles and authorization.

• Refer or assist with enrollment plans. including documenting coverage of meds.
• Maintained estimated patient financial responsibility based off benefit verification & payor contracts and/or company self-pay pricing.
• Initiate, follow-up and secure prior authorization or medical review including reviewing and obtaining clinical documents for submission purposes.

• Performed daily and weekly inventory control for the various merchandise in the stores.
• Provided excellent customer service and performed cashier duties including count change, opening/closing register, and completing transactions.
• Maintained sanitation and general convenience store product management.
• Resolved customer complaints, complied & maintained non-monetary reports and records responsible for organizing stock and keeping the services area clean.

• Knowledge of prescriptions drug reimbursements, including insurance plan types.
• PBM and major medical benefits, prior authorizations & appeals processing.
• Prepared of medicare benefits, enrollments and LIS assistance

• Taking in/out bound calls for customers and providers.

• Made judgement and decision-making skills in dealing with customers complaints and sensitive request required.

• Liaise between managers, customers, and employees, fill in for general manager.
• (GM) in times of absence.
• Make executive decisions, hold meetings, and provide accountability.
• Developed strategies for better workplace efficiency and goal achievement.
• Monitored spending patterns and budgets.

• Qualified to accurately obtain and process patient demographic, medical & insurance information.
• Responded to incoming calls via queue from our customers on issues related to benefit eligibility questions and prescriptions status inquires.
• Identify issues and communicated solutions and steps to customers. with prescriptions orders and reorders.
• Provided education to customers on their, plans, formulary and others.