Tony Wright
McKinney,TX
Summary
Enthusiastic and customer-focused pharmacy assistant with strong expertise in patient care, healthcare reimbursement, and sales support. Skilled in delivering exceptional customer service, assisting patients with medication needs, and guiding them through insurance and reimbursement processes. Adept at identifying opportunities to recommend products and services, ensuring a positive patient experience while contributing to pharmacy sales and operational efficiency.
Experienced with insurance verification processes, ensuring accurate and timely handling of patient information. Utilizes strong analytical skills to identify and resolve discrepancies, maintaining seamless operational flow. Knowledge of industry regulations and best practices, contributing to overall efficiency and reduced claim rejections.
Overview
12
12
years of professional experience
Work History
Insurance Verification Specialist
Medix Infusion
11.2024 - 05.2025
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Achieved insurance pre-authorizations to enable timely patient procedures.
Pharmacist Assistant
Walgreens Specialty Pharmacy
08.2018 - 04.2024
- Verify patient insurance coverage and benefits, including eligibility, co-pays, prior authorizations, and formulary restrictions, utilizing electronic verification systems and contacting insurance providers as needed.
- Communicate with patients, physicians' offices, and insurance companies to resolve insurance-related issues, obtain necessary authorizations, and facilitate medication coverage.
- Accurately enter insurance and prescription information into pharmacy management software, ensuring compliance with HIPAA regulations and maintaining patients confidentiality.
- Assist pharmacists in filling prescriptions, compounding medications, and maintaining inventory levels to meet patient demand and ensure timely medication dispensing.
- Provide exceptional customer service, addressing patient inquiries, resolving medication-related concerns, and educating patients on medication usage and adherence.
- Collaborate with pharmacy team members to streamline workflow processes, improve efficiency, and enhance overall pharmacy operations.
- Achievements/Tasks
Reimbursement Counselor
Amerisource Bergen
02.2013 - 05.2018
- Collect and reviewed all patient insurance benefit information to the degree authorized by the sop of the program.
- Handled insurance claim denials, working directly with insurance companies to resolve issues such as policy termination or outdated medical records.
- Ensure claims are updated and processed in a timely manner by corresponding with insurers to gather the necessary information.
- Managed the end-to-end billing process for Medicare and Medicaid claims.
- Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
- Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third-party payers. Researches and resolves any electronic claim denials.
- Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
- Achievements/Tasks
Education
Study Program -
Mesa Ridge High School
Colorado Springs, CO05.2000
Skills
- Customer Service Excellence
- Healthcare Reimbursement
- Insurance Verification
- Medicare/Medicaid
- HIPPA compliance
- Insurance billing
Timeline
Insurance Verification Specialist
Medix Infusion
11.2024 - 05.2025
Pharmacist Assistant
Walgreens Specialty Pharmacy
08.2018 - 04.2024
Reimbursement Counselor
Amerisource Bergen
02.2013 - 05.2018
Study Program -
Mesa Ridge High School
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