Summary
Overview
Work History
Education
Skills
Timeline
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SANGEYA LOWE

Arlington,TX

Summary

Highly motivated and compassionate healthcare support professional with over 10 years of experience in patient services, insurance reimbursement, prior authorizations, and administrative operations. Proven track record of managing high-volume caseloads, securing financial assistance, and navigating complex payer systems. Adept at using EMR systems, ensuring regulatory compliance, and providing top-tier patient advocacy. Recognized for delivering accuracy, efficiency, and excellence in fast-paced environments.

Overview

16
16
years of professional experience

Work History

Reimbursement Case Manager

CareMetx
02.2024 - Current
  • Manage full reimbursement lifecycle for specialty medications including benefit verification, prior authorization, and copay assistance.
  • Serve as a liaison between patients, providers, and payers to expedite access to care.
  • Educate patients on financial assistance programs and communicate application outcomes.
  • Maintain accurate, up-to-date case documentation and benefit summaries.

Reimbursement Specialist

CareMetx
12.2022 - 02.2024
  • Verified insurance coverage and processed reimbursement claims.
  • Resolved benefit coverage issues through payer/provider collaboration.
  • Delivered high-quality, time-sensitive service while managing multiple cases daily.

Pre-Enrollment Specialist

Willis Towers Watson
08.2022 - 12.2022
  • Supported Medicare patients with plan enrollment and eligibility questions.
  • Delivered administrative and technical assistance for digital enrollment tools.
  • Assisted clients in completing reimbursement forms and verifying coverage details.

National Operations Coordinator

Peloton
10.2021 - 03.2022
  • Company Overview: Contract Role
  • Coordinated nationwide delivery schedules and logistics operations.
  • Maintained CRM system data integrity and resolved service issues to ensure on-time deliveries.
  • Contract Role

Patient Care Coordinator

AllianceRx Walgreens Prime Specialty
11.2016 - 08.2020
  • Processed specialty prescriptions, verified insurance, and managed patient deliveries.
  • Provided cross-departmental support to resolve inquiries and ensure care continuity.

Workforce Management Associate

AllianceRx Walgreens Prime Specialty
10.2018 - 05.2019
  • Designed staffing schedules aligned with forecasted service needs.
  • Analyzed call center metrics to enhance staffing efficiency.

Customer Service Agent

iQor
10.2014 - 11.2016
  • Handled billing, account management, and payment processing in a high-volume call center.
  • Maintained quality scores through consistent customer satisfaction.

Short-Term Loan Manager

First Cash Pawn
01.2009 - 01.2014
  • Led daily store operations including short-term loan approvals and staff supervision.
  • Boosted retention through effective customer service and local marketing.

Education

Certified Medical Assistant - undefined

Platt College
Dallas, TX

Skills

  • Insurance Verification & Prior Authorizations
  • Medicare
  • Medicaid
  • Commercial Payers
  • EMR Systems
  • Medical Coding (ICD)
  • Copay Assistance
  • Financial Program Navigation
  • Case Management
  • Patient Advocacy
  • Call Center
  • High-Volume Workflows
  • CRM/ERP Software
  • Microsoft Office Suite
  • Workflow Optimization
  • Data Accuracy

Timeline

Reimbursement Case Manager

CareMetx
02.2024 - Current

Reimbursement Specialist

CareMetx
12.2022 - 02.2024

Pre-Enrollment Specialist

Willis Towers Watson
08.2022 - 12.2022

National Operations Coordinator

Peloton
10.2021 - 03.2022

Workforce Management Associate

AllianceRx Walgreens Prime Specialty
10.2018 - 05.2019

Patient Care Coordinator

AllianceRx Walgreens Prime Specialty
11.2016 - 08.2020

Customer Service Agent

iQor
10.2014 - 11.2016

Short-Term Loan Manager

First Cash Pawn
01.2009 - 01.2014

Certified Medical Assistant - undefined

Platt College

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SANGEYA LOWE