Tamara Williams

SK Life Science program that provide medication for patient that suffered from epilepsy. That control seizure by 95%.

• Awarded for Quality review averaging 95% for decreased errors for process improvement, metrics and were data study shows increase patient process for new patients from 10-24 patients in Salesforce.
• Implement created template task document for missing documents in order speed up process for new enrollment patients.
• Working closely with Director, Quality Manager, Program Manager’s to assess 5-10 cases and plan strategies for enhancing care for urgent enrollment and medication request.
• Leading professional employees for Data Entry on account created demographic, Provider account, prescription, insurance carrier, and retail pharmacy for medication approval.
• Leverage experience with PAP Assistance Program to assist patient that have commercial Insurance, zero Income and to help patients that can’t meet their co-pay or deductible coverage to offset medication of 6k month.

Managed and operated home care patient that had health needs with rare disease and mental health concerns to average of 3 clients per week. Increasing budget from $0 to 60k yearly.

• Collaborated as part of team of with physicians, nurses or other healthcare professionals to manage patient care by assisting with medical procedures or related duties.
• Drove operational improvements which resulted in savings from 20% and 40%improved profit margins.
• Interacted effectively with patients, families, staff and other hospital department staff to deliver excellence customer service.
• Advocate for clients while coordinating with service, techniques and find alternatives to healthy life styles and provide resources to local agencies and health needs.
• Educated patients about procedures, answered questions and provided comforting words to control anxiety, stress management and enhance procedure results.
• Saved patient life by advocating to receive proper medication and medication management.
• Adopting healthy habits and news to developing strong relationships.

Achieved 95% success rate, counseling and advocating for patient regarding pre-qualification eligibility requirements for NC Stated funded program.

• Increased clients served daily from five to 10+developing strategic plans while verifying excellent services, providing exceptional individual support.
• Providing intensive 1:1 support 10+ clients per day (initial target goal 5).
• Participated in COVID-19 Support Services program that provided financial relief, home- delivered groceries or meals, transportation, and delivery of medication for COVID-19 supplies.
• Using problem solve skills to research non-profit organization to assist client with resources in diverse community population.
• Managed enrollment, transportation and paperwork for individuals to take advantage of community and non-profit organization for case denials to suitable resources.
• Explained required eligibility applications to patients and helped complete applications for services.

Lead Medical Screeners navigating on protocols for support facility entry and testing as well emergency response for COVID-19.

• Implemented safety measures and provided front-line support for COVID-19, screened all employees before entering facility daily.
• Referred for additional testing, and to determined exposure and risk to others.
• Assisted employees, visitors, and vendors with COVID-19 screening as per CDC guidelines.
• Report potential cases contact tracing to North Carolina Health Department.
• Collaborate with Executives and Stakeholders on any COVID-19 updates and changes to policy requirement.
• Completed necessary reports and documentation on time and to specifications

Awarded and Recognized for Managed patient database, including benefit verification and eligibility determination by decreasing errors with 95% for approval for drug product program to offset medical cost.

• Collaborate with Senior Management to successful meet deadline on closing projects on pharmaceutical top name brand drug's program for budget of 1 million PAP Assistance Program to offset drug cost to help patients.
• Triaged cases with missing information to appropriate program associate
• Explained benefits to plan participants in easy to understand terms in order to educate each patient on benefit plan options.
• Verified patient-specific benefits and precisely documented specifics for various payer plans including patient coverage, cost-share, and access/provider options pharmaceutical supply chain.
• Utilized metrics, analytics, data synthesis, and business intelligence to identify trends, delays, produce reliable forecasts and projections for leadership team.

Awarded as the “top ten employees” out of 50 Reimbursement Counselor for demonstration of operational excellence with consistently processing patient benefits with 100% accuracy and zero errors exemplary performance productivity.

• Identified and reviewed services to verified benefits, Initiate pre-authorization/pre-certification by Medicare, Medicaid, Commercial Insurance, Medicare Advantage, and Supplement insurance benefits, and tier structure plans for patients.
• Acted as resource for Health Care providers and patients for pharmaceutical medications.
• Managed financial support programs such as prescription and co-pay assistance to evaluate patient insurance benefits to cover retail pharmacies and Specialty drug medication.
• Served as expert on payer trends and reporting any reimbursement trends/delays such as billing denials, claim denials, pricing errors, and payments
• Guided and trained employees on using online database and troubleshoot database issues
• Assist and educate patients for PAP and Co-pay assistance eligibility to gain access to chemotherapy, oncology, home health, dialysis clinics medical service.
• Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.

Directed the transition from paper chart to Epic System. Training physician and healthcare personnel on transferring and scanning all medical documents using Medical Management software.

• Used coordination and planning skills to achieve results according to physicians schedule for home visit.
• Obtained client medical history, medication information, symptoms and allergies average 15-20 patients per day.
• Educated patients about medications, procedures and care plan instructions for instructed by provider.
• Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
• Called and faxed pharmacies to submit prescriptions and refills.
• Collected and documented patient medical information such as blood pressure and weight, vital signs.
• Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment medical care.