Summary
Overview
Work History
Education
Skills
Certification
Timeline
SeniorSoftwareEngineer

Patricia McFarland

Smithfield

Summary

Compassionate Healthcare Customer Service Representative known for high productivity and efficient task completion. Skilled in patient communication, data entry accuracy, and healthcare policy understanding. Excel in active listening, empathy, and problem-solving to enhance patient satisfaction and support team objectives.

Overview

4
4
years of professional experience
1
1
Certification

Work History

Case Manager

Cencora
09.2024 - Current
  • Reviews patient assistance program enrollment forms ensuring that there isn't any missing information that could delay services
  • Addresses patient inquiries and concerns in order to resolve and de-escalate issues in a timely and empathetic manner
  • Applies HIPAA privacy and security regulations while handling patient information
  • Handles 20-30 incoming phone calls providing exceptional customer service skills to the patient and the family
  • Processes insurance verifications and authorizations to ensure that patient receives the necessary goods and services

Certified Medical Assistant

UNC Health Care
Clayton
04.2024 - 08.2024
  • Answered patient calls to address any concerns or issues that may need to be addressed and resolved by clinical staff
  • Assessed, documented, and monitored vital signs for patients within outpatient setting
  • Conducted patient interviews to gather health history, vital signs and information about current medical issues
  • Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment
  • Obtained insurance authorizations for prescribed medications or treatments for patients in need of financial assistance programs

Patient Access Representative

Cencora
08.2023 - 08.2024
  • Collaborated with other departments to ensure quality customer service was delivered
  • Verified documentation methodically to avoid critical errors impacting care delivery and payments for services
  • Scanned documents into electronic medical records system
  • Participated in training sessions to stay updated on healthcare policies and registration software
  • Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care

Prior Authorization Specialist

Wakemed
Raleigh
11.2021 - 08.2023
  • Submit prior authorizations and clinical documentation to insurance companies for medications, procedures, and medical devices
  • Completed benefit verification investigations to determine coverage for services.
  • Followed up on prior authorizations, requesting appeals, if applicable.
  • Reviewed denials or approvals with the patient researching other alternatives, if needed.
  • Research and exhaust all levels of appeals offered by the insurance company.

Education

Associate of Applied Science - Healthcare

Johnston Community College
Smithfield, NC
05.2021

Associate of Applied Science - Business Administration And Management

American InterContinental University
Schaumburg, IL
04.2012

Skills

  • Inbound and outbound calling
  • Customer service
  • Electronic health records
  • Insurance claims
  • Prior Authorization
  • Denials and appeals
  • Multitasking and organization
  • HIPAA compliance
  • Health history documentation
  • Documentation and reporting

Certification

  • Certified Medical Assistant (AAMA)
  • BLS

Timeline

Case Manager

Cencora
09.2024 - Current

Certified Medical Assistant

UNC Health Care
04.2024 - 08.2024

Patient Access Representative

Cencora
08.2023 - 08.2024

Prior Authorization Specialist

Wakemed
11.2021 - 08.2023

Associate of Applied Science - Healthcare

Johnston Community College

Associate of Applied Science - Business Administration And Management

American InterContinental University

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Patricia McFarland