Rosalyn Bush
Indianapolis ,IN
Summary
Accomplished Eligibility and Prior Authorization Specialist with a proven track record at Express Scripts, adept in data entry and effective communication. Demonstrated success in enhancing client satisfaction and reducing authorization turnaround times through meticulous eligibility verification and leveraging Microsoft Office for streamlined operations. Achieved a high success rate in obtaining authorizations, showcasing a strong work ethic and team collaboration skills.
Experienced with eligibility determination, client assessment, and regulatory compliance. Utilizes advanced problem-solving skills to handle complex cases efficiently. Track record of effective communication and collaborative teamwork in high-pressure situations.
Overview
10
10
years of professional experience
Work History
Eligibility Specialist
Accredo Specialty Pharmacy
10.2018 - 08.2024
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Verified patient insurance eligibility and entered patient information into system.
- Skilled at working independently and collaboratively in a team environment.
- Organized and detail-oriented with a strong work ethic.
- Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
Prior Authorization Specialist
Express Scripts
11.2014 - 10.2018
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Utilized computer programs to create invoices, letters and other documents.
- Reached out to insurance carriers to obtain prior authorization for specialty medications.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Electronically submitted prior authorization request according to compliance guidelines.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Verified eligibility and compliance with authorization requirements for service providers.
Education
No Degree - Medical Assistant/ Bio Chemist
Med Tech
Indianapolis, INHigh School Diploma -
Southport High School
Indianapolis, IN05-1985
Skills
- Data Entry
- Effective communication skills
- Microsoft Office
- Telephone Etiquette
- Eligibility Determination
Timeline
Eligibility Specialist
Accredo Specialty Pharmacy
10.2018 - 08.2024
Prior Authorization Specialist
Express Scripts
11.2014 - 10.2018
No Degree - Medical Assistant/ Bio Chemist
Med Tech
High School Diploma -
Southport High School
Similar Profiles
Yazmin MurrayYazmin Murray
Senior Billing Representative at Accredo Specialty PharmacySenior Billing Representative at Accredo Specialty Pharmacy
Tina McDadeTina McDade
Patient Care Advocate at Accredo Specialty PharmacyPatient Care Advocate at Accredo Specialty Pharmacy
Amanda OrtizAmanda Ortiz
Customer Service Lead at Accredo Specialty PharmacyCustomer Service Lead at Accredo Specialty Pharmacy