Tammie Stewart
Charlotte,NC
Summary
Hardworking, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs and increase service value. Seeking to utilize excellent communication, interpersonal, and organizational skills to complete tasks. Reliable with a good work ethic and the ability to quickly adapt to new tasks and environments.
Overview
9
9
years of professional experience
Work History
Reimbursement Case Manager
Caremetx LLC
Bethesda, Md
11.2021 - Current
- Acts as single point of contact and voice for all providers and patients. Works as a patient advocate and demonstrates compassion at all times.
- Coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support services.
- Manages a regional case load.
- Collects and review all patient information, to the degree authorized by the SOP of the program.
- Validates completeness of all required information and provides assistance to provider and/or patient.
- Provide guidance to physician office staff and patients on how to complete and submit all necessary program applications in a timely manner.
- Determines patient’s eligibility and conducts patient enrollment activities.
- Provide exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
- Maintain frequent phone contact with patients, provider representatives, third party customer service representatives and pharmacy staff.
- Provides reimbursement information to providers and/or patients.
- Work on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercise judgment within defined standard operating procedures to determine appropriate action.
- Must be knowledgeable of HIPAA regulations and HIPAA compliant at all times.
Care Manager
Allcare Plus Pharmacy
Northborough, Massachusetts
07.2019 - 06.2020
- Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures
- Provide customers with courteous, friendly, fast and efficient service
- Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance program
- Update job knowledge by participating in educational opportunities and training activities
- Complete prior authorizations with attention to detail and accuracy, to then have the prepared prior authorizations reviewed by a clinical pharmacist
- Assist field team members with pharmacy communication, accurate information regarding specialty pharmacy triage and shipment coordination
Sr Reimbursement Counselor
Lash Group
Ft Mill, South Car
09.2016 - 07.2019
- Sr. Reimbursement Counselor/Patient Access Specialist
- Provide advanced services to patients, providers and field team members and caregivers
- Perform advanced alternate coverage research, claims assistance, tracking and submission, prior authorization assistance and tracking, welcome calls, benefit verification result call appeals and denials and billing and coding support.
- Provide weekly calls to field staff regarding patient status for eligible patient assistance programs and weekly reports reflecting next steps action detail
- Provide customer services and maintain phone contact with Physicians (staff), Field Sales Representatives, Pharmacy Staff (PBMs), and various other third party customer service reps to ensure quality patient care and treatment
- Processes any necessary correspondence
- Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action
- Applies company policies and procedure to resolve a variety of issues
Education
Bachelor of Arts (B.A.) - Applied Psychology
UNC-CH
Chapel Hill, North Carolina12.2026
Skills
- Problem Solving
- Customer Service
- Care Coordination
- Data Analysis
- Attention to Detail
- Case Documentation
- Active Listening
- Multitasking Abilities
- Time Management
ADDITIONAL INFORMATION
I have completed the coursework for the CRC Certification and scheduled to take the national exam via AAPC in August of 2024.
Timeline
Reimbursement Case Manager
Caremetx LLC
11.2021 - Current
Care Manager
Allcare Plus Pharmacy
07.2019 - 06.2020
Sr Reimbursement Counselor
Lash Group
09.2016 - 07.2019
Bachelor of Arts (B.A.) - Applied Psychology
UNC-CH