Roxanne Amavisca

Duties included the following

Processing and verifying new referrals

Verifying insurance and eligibility

Submitting both prior authorization and appeals

Submitting new applications for free drug and copay assistance

Ordering medication and supplies for all Arizona infusion clinics and maintaining inventory

Ordering specialty medications for all specialty patients from other specialty pharmacies

• Responsible for verifying insurances and processing home health referrals for in home skilled nursing, physically therapy, occupational therapy, speech therapy and other in home health care needs also responsible for coordinating and staffing patients with the home health agencies.

• Maintains inventory for 36 plus aic infusion clinics
• Lead medication and supply purchaser
• Main contact for all medication and supplies for clinical staff
• Maintains all accurate count of medication and supplies on hand and at clinic
• Intake coordinator
• Scheduling
• Familiar with wholesalers such as( cardinal, MS, curascript, mckesson specialty etc.
• Intake coordinator- verifying insurances, and Scheduling

• Responsible for all IV home infusion referrals, verifying all health insurance and running test claims for all medical part D plans as well as collecting all correct medical documentation from hospitals, and other medical facilities and coordinating with Pharmacy and nursing.

• Responsible for all physician billing for all St. Joe’s Medical clinics processing ub form, Iz statements and medical records as well as claims and collections.

• Responsible for processing new set ups and reorder supplies for respiratory and DME patients. Qualify patients for oxygen and PAP therapy. Stay in accordance with insurance guidelines to assure 100% reimbursement. Take high volume inbound calls. Assure all follow ups are done in a timely manner. Stay in contact with referral sources regarding patient services.

• Process all incoming referrals for new home infusion setups as well as process current refill requests. Responsible for taking high volume inbound calls, and also make outbound calls to assure all orders are processed in a timely manner. Follow all insurance guidelines and relay correct insurance coverage to all customers. Submit prior authorization when necessary to health plans. Responsible for creating new intakes and assuring data entry is done correctly.

• Responsible for processing new set ups and reorder supplies for respiratory and DME patients. Qualify patients for oxygen and PAP therapy. Stay in accordance with insurance guidelines to assure 100% reimbursement. Take high volume inbound calls. Assure all follow ups are done in a timely manner. Stay in contact with referral sources regarding patient services.

• Process incoming Infusion, Enteral, Negative pressure wound Therapy, Ostomy and Urological orders.
• I worked intake process for IV home infusion and scheduled patients with home health agencies. On down time I processed intakes for new patients and processed refills for enteral services. Assisted with supply orders for urological, wound care and ostomy. My duties also included high volume inbound and outbound calls from patients, referrals and internal customer service.

• Analyzing health insurance claim forms, such as CMS-1500 and UB04 billing forms. Acting in a Lead role for my peers with one on one on the job training and assisting management with admin support as well as Quality Assurance in every department within the company. Answering and making telephone inquiries regarding insurance benefits, eligibility, and authorization. Utilizing and updating computer databases and researching the internet for health information including ICD-9 and other medical codes. Reviewing/advising on health insurance claims for Customers and Providers and analyzing pricing of claims. Process orders and pharmacy prescriptions using company databases and other company computer programs.