Hi, I’m
Phebe Moche
Mesa,AZ
Summary
I am resourceful and results-focused specialist, providing exceptional patient care, organization, time management, attention to detail and communication skills to deliver results aligned with organizational goals and objectives. Working with a high degree of accuracy in providing services and ensures all assignments are completed in a timely accurate manner while following all applicable protocols and regulations. Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.
Overview
11
years of professional experience
Work History
Cencora
Patient Account Specialist
01.2023 - Current
Job overview
- Under the general supervision of an Operations Manager, I thoroughly review and make determinations on various services including but not limited to reimbursement activities, claim submission, claim status, collection activity, appeals, patient assistance and copay assistance
- On a day-to-day basis I am in contact with various customers of our services including but not limited to patients, providers, caregivers, and client brand teams.
- Independently analyzes, reports, resolves, and communicates any reimbursement trends/delays (e.g., billing denials, claim denials, pricing errors, payments, etc.).
- Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate.
- Works on complex issues where analysis of situations or data requires in-depth evaluation of variable factors
- Exercises judgment in selecting methods, techniques, and evaluation criteria for obtaining results
- Networks with key contacts outside one’s area of expertise.
Banner Health
Patient Access Specialist
01.2020 - 01.2022
Job overview
- Supporting Banner Health to provide high quality and exceptional customer service in a multi-function role
- Assisting patients with registration, point of service collections, validating or obtaining authorizations, detailed documentation and demonstrating consistent knowledge in executing pharmaceutical care all in effort of Making health care easier, so life can be better.
- Acting as a liaison between the patient, the billing department, vendors, physician offices and the payor to enhance account receivables performance and meet payment collection goals, resolve outstanding issues and/or patient concerns and maximize service excellence.
- Communicating with physicians, clinical and hospital staff, nursing and Health Information management services to resolve outstanding issues and/or patient concerns
- Verifying ICD10, and CPT Codes and working to meet the patient’s needs in financial services.
- Working remotely under regular supervision and following structured work routines
- Working in a fast paced, multitask environment with high volume and immediacy needs that require independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care.
American Health Group
Intake Representative
01.2017 - 01.2020
Job overview
- Supporting American Health Group with responsibility of working with customers to verify certifications and insurance authorization to determine eligibility for services
- Demonstrating consistent application of knowledge in executing pharmaceutical care.
- Performing routine clerical duties, ensuring that precertification applications are processed in an effective and efficient manner, and providing a positive experience for the customer and maintaining high service standards.
- Gather and analyze all required information and communicated with customers to help answer and resolve any questions or concerns.
- Manage a high volume of phone inquiries from providers, facilities, and members, assess callers needs and assist them with their needs, ability to utilize the computer data base to enter, verify, and document information and provide excellent customer service.
XEROX
Precertification Specialist/Medicare Pharmacy Tech
01.2013 - 01.2015
Job overview
- Supported CVS Caremark and Aetna campaigns with responsibility for working with customers and verifying certifications and insurance authorization to determine eligibility for services
- Demonstrated consistent application of knowledge in executing pharmaceutical care.
- Performed appropriate searches, reviewed plan documentation and clinical information to determine appropriate coverage and ensured clinical guidelines and eligibility criteria were met.
- Gathered and analyzed all required information and communicated with customers to help answer and resolve any questions or concerns.
- Completed over 60 faxes per day, 100 outbound phone calls, and 250 inbound phone calls
Education
Wake Technical Community College
Associate in applied arts from Advertising and Graphic Design
Excel Caregiving Training School
Caregiver
HFMA
Certified Revenue Cycle Representative
HFMA
Certified Revenue Capture and Recognition
HFMA
Health Information Management (HIM) and Coding
Clarivate Learning
Certified Patient Financial Services Specialist
Clarivate Learning
Certified Patient Access Specialist
Skills
- Professional Interpretation
- Insurance Verification
- Authorizations
- CPT Coding
- Patient Care Management
- Communication
- Process Management
- Clinical Review
- Documentation/Reporting
- Customer Service
- Problem Solving / Solutions
- Critical Thinking
- Compliance Management
- Pharmaceutical Support
- Safety Oriented MS4
- Cerna
- Flywire/Simple
- Genesis
- Teams
- Microsoft Office Suite (Excel, PowerPoint, Word)
- Adobe Creative Suite 4-5 (Dreamweaver, Illustrator, InDesign, Photoshop)
- Specialized Software Systems (CAS, Medhok, People Safe, Rx Claim)
- Therapy source
- RT billing system
- Internet Research
Volunteer Experience
- Arizona Swahili Radio- 2019-current
- Future Design Association- Spring 2012
- Habitat for Humanity – 2012-present
- United Brethren Restoration Center- 2008- present
- Kenyan Christian Fellowship of America- 2007- present
Timeline
Patient Account Specialist
Cencora
01.2023 - Current
Patient Access Specialist
Banner Health
01.2020 - 01.2022
Intake Representative
American Health Group
01.2017 - 01.2020
Precertification Specialist/Medicare Pharmacy Tech
XEROX
01.2013 - 01.2015
Wake Technical Community College
Associate in applied arts from Advertising and Graphic Design
Excel Caregiving Training School
Caregiver
HFMA
Certified Revenue Cycle Representative
HFMA
Certified Revenue Capture and Recognition
HFMA
Health Information Management (HIM) and Coding
Clarivate Learning
Certified Patient Financial Services Specialist
Clarivate Learning
Certified Patient Access Specialist
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