Tammy Thompson

• Delivers understanding and supportive care to patients facing challenging medical circumstances, building trust and rapport.
• Streamline communication channels between patients, families, physicians, and other healthcare professionals by serving as a liaison.
• Implements effective follow-up procedures to monitor patient progress and ensure timely interventions when necessary.
• Improve patient communication by developing informational materials on treatment options and procedures.
• Addresses reimbursement related inquiries, assess patients’ coverage options, provide eligibility and benefit verification, secure insurance authorizations, advocate for maximum reimbursement coverage and provide patient assistance for those in need of financial support.
  

• Reviews inbox for daily work queues, identifies missing evidence and follows through to completion.
• Answers incoming calls from clients and Health Care Representatives regarding State and Federal claims
• Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process.
• Assists clients with scheduling appointments and reminding of appointments, as needed.
• Maintains ongoing communication with other internal Resolve Application functions to obtain information and/or provide updates regarding claim status.
• Identifies and takes appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process.

• Managed high volumes of customer inquiries for efficient resolution, enhancing overall client experience.

• Delegated daily tasks, addressed employee questions and resolved scheduling issues.
• Managed team workload to reach targets for specific tasks.
• Built strong relationships with customers through positive attitude and attentive response.
• Managed multiple projects simultaneously, prioritizing tasks for optimal resource allocation and workflow efficiency.
• Tracked progress on initiatives.
  • Interfaced and engage with associates at least 50% of the time to assist with answering questions and provide mentoring.
  • Understands program contract obligations and able to communicate in order to drive program performance.
  • Identifies problems, investigates, recommends, and implements solutions to reimbursement issues.

• Served as a subject matter expert within the organization on complex reimbursement scenarios, consistently delivering accurate solutions.
• Mentored junior reimbursement specialists, providing guidance on best practices and industry standards for optimal performance.
• Conducted comprehensive reviews of medical documentation to ensure appropriate levels of support were provided for each claim submitted.
• Trained new team members on internal systems and procedures, fostering a collaborative work environment focused on continuous improvement.
• Maintained up-to-date knowledge of coding changes, payer policies, and regulatory requirements to ensure compliance in all reimbursement activities.

• Managed accounts in a specified region for mental health therapeutic area to provide reimbursement education to HCP office personnel involved in reimbursement matters.

• Educated provider offices and staff in resolving complex coverage and reimbursement issues that may create barriers to access for patients.
• Frequent interactions with key stake holders in multiple sites of care including physician practices, hospital inpatient, hospital out-patient departments and other related facilities.
• Establish relationships within a practice by working closely with them to help remove access barriers to specialty products for their patients.
• Provide education on the product services to support patient access to therapy.

Educated HCP’s and office staff on buy-bill, specialty pharmacy, and infusion reimbursement topics related to Abilify Maintena, Rexulti, Abilify and Samsca for the treatment of patients with schizophrenia, Bipolar, Major depressive disorder and low serum sodium.

• Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
• Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
• Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
• Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
• Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
• Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.