Shanika Davis
McKees Rocks,PA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
16
16
years of professional experience
Work History
06.1998
Insurance Resolution Specialist
Specialty Pharmacy
10.2018 - Current
- Verify patient pharmacy coverage & processing info
- Ability to process pharmacy claims on the patient’s behalf through a pharmacy systems
- Obtain authorizations & overrides as needed
- Apply patients for copay cards and/or assistance programs
- Prepare and process medical insurance claim forms and records
- Discussion with patient to review patient financial responsibility, obtain patient consent and payment
- Ensure proper shipment set up
- Handled customer inquiries and suggestions courteously and professionally.
Specialist
Walgreens Specialty Pharmacy
06.2018 - 10.2018
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Processed eligibility and benefits verification and authorization requests.
- Resolved discrepancies in insurance payments by collaborating with carriers.
- Maintained confidentiality of patient finances, records, and health statuses.
Work Coordinator
Caremark Specialty Pharmacy
10.2007 - 12.2017
- Process quality control reports on monitored call center employees inbound calls
- Report the productivity of the call center employees
- Resolving supervisor escalated calls and executing call backs when necessary
- Make decisions and exercise good judgment
- Identify participant issues and worked diligently to resolve
- Positively deal with changes in a complex and rapidly changing environment
- Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
- Reviewed accounts receivable reports, insurance contracts and weekly and monthly financial reports.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
Education
Diploma - Medical Assisting
Western School Of Health
Pittsburgh, PA06.1998
Skills
Consultative Sales Approach
- Persuasion Techniques
- Microsoft Excel
- Customer Feedback
- Service Quality
- Performance Strategies
- Customer Relations
Timeline
Insurance Resolution Specialist
Specialty Pharmacy
10.2018 - Current
Specialist
Walgreens Specialty Pharmacy
06.2018 - 10.2018
Work Coordinator
Caremark Specialty Pharmacy
10.2007 - 12.2017
06.1998
Diploma - Medical Assisting
Western School Of Health
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