Summary
Overview
Work History
Education
Skills
Timeline
Generic

Samantha Woods

Bonne Terre,MO

Summary

Certified Pharmacy Technician with background in billing, retail, and long-term care. Trained in Frameworks and ICOMS or dispensing and inventory management. Successful career history working with insurance companies to achieve coverage and understand formularies. Licensed in Missouri.

Overview

9
9
years of professional experience

Work History

Claims Analyst II

Centene Corporation
02.2021 - Current
  • Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
  • Managed OMNI production inbox to ensure cases are resolved in a timely and satisfactory manner.
  • Resolved aging claims involving requests from another department.
  • Generated, posted and attached information to claim files.
  • Processed claims per company guidelines.
  • Maintained 100% accuracy in claims processing.
  • Advanced Analyst trained.
  • Coordination of Benefits trained.
  • Accurate data entry for rekeys and other claims processing requirements.
  • Lead team development opportunities to enhance productivity.
  • Supported team members by creating helpful resource guides.
  • Maintained strict confidentiality with all personal data as per company guidelines.

Certified Pharmacy Technician

Health Direct
12.2020 - 02.2021
  • Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
  • Coordinated verification and filling of more than 120 daily prescriptions in high-volume pharmacy environment.
  • Set up and modified patient profiles in Frameworks to include current information such as medications and insurance details.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency and service quality.
  • Resolved non-routine issues like third party billing, computer system and customer service issues.
  • Verified patient data and billing information to discover and resolve erroneous bills due to system errors.
  • Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.
  • Processed incoming drug orders.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.

Certified Pharmacy Technician

Walgreens
09.2018 - 12.2020
  • PTCB Certified
  • Stocked, labeled and inventoried medication to keep accurate records
  • Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments
  • Set up and modified patient profiles in ICOMS to include current information such as medications and insurance details
  • Restocked automated medication dispensing equipment
  • Completed paperwork, entering prescription and insurance or billing information into patient profiles
  • Communicated directly with doctors offices via telephone, fax, and email
  • Coordinated verification and filling daily prescriptions in high-volume commercial pharmacy environment

Billing Specialist

STARTEK
10.2017 - 09.2018
  • Reviewed and solved account and billing discrepancies
  • Coordinated with intermediate parties to obtain payments and resolve issues
  • Received incoming information and entered into database system
  • Trained new staff on quality control procedures
  • Self-directed with astute judgment skills. High level of personal accountability
  • Worked simultaneously with multiple systems on a dual monitor computer
  • Answered inquiries and addressed, resolved or escalated issues to management personnel to ensure client satisfaction
  • Maintained current knowledge of all team position requirements
  • Worked with new hire employees to ensure an understanding of the computer system and customer handling strategies
  • Regularly placed as a top performer in site

Key Holder

Dollar General
02.2016 - 10.2017
  • Completed administrative work such as scheduling, bank deposit and sales reports
  • Supervised associates throughout each assigned shift and managed any arising challenges
  • Answered customer telephone calls promptly and in an appropriate manner
  • Completed all point of sale opening and closing procedures, including counting the contents of the cash register
  • Fostered a positive work environment by consistently treating all employees and customers with respect and consideration
  • Actively pursued personal learning and development opportunities
  • Completed all cleaning, stocking and organizing tasks in assigned sales area

Education

High School Diploma -

Bismarck RV
Bismarck, MO
2012

Mineral Area College
Park Hills, MO

Skills

  • Data entry
  • MS office
  • Data Analysis
  • Problem resolution
  • Claims analysis
  • Proficient in Amisys, CenPAS, OMNI prod, batch claims submissions
  • Claims processing
  • Claims adjustment
  • Teamwork and collaboration
  • Articulate and well-spoken
  • Employee training and development
  • Coaching and mentoring

Timeline

Claims Analyst II

Centene Corporation
02.2021 - Current

Certified Pharmacy Technician

Health Direct
12.2020 - 02.2021

Certified Pharmacy Technician

Walgreens
09.2018 - 12.2020

Billing Specialist

STARTEK
10.2017 - 09.2018

Key Holder

Dollar General
02.2016 - 10.2017

High School Diploma -

Bismarck RV

Mineral Area College

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