Tracy Davenport
Whitesboro,TX
Summary
Detail-oriented team player with strong organizational and communication skills. Looking to obtain a position within a company that provides career development, empowers employees to create results, and recognizes contribution through advancement.
Overview
13
13
years of professional experience
Work History
Pharmacy Benefit Specialist
TTEC Services
10.2023 - Current
- Field constant incoming calls from Doctors, Pharmacists, and patients. Improved caller's understanding of patient pharmacy benefits consisting of formulary, phase of coverage, copay structure, deductible, and accumulators
- Create mail order accounts, place prescription orders, fax providers for refills, update customer payment and location information as needed
- Rectification of pharmacist inquiries by assisting with adjudicating prescription claims, entering overrides according to allowed plan benefits, and initiating Prior Authorizations
- Ensuring all systems are updated with informative documentation of patient request and resolution
Care Advocate
Wellmed Medical Management
05.2021 - 02.2023
- Established and maintained relationships with multiple Primary Care Physicians, High Risk and recently discharged patients
- Summarized patient progress and presented detailed updates to PCP’s during weekly virtual meetings
- Coordinated phone interviews with patients, weekly or bi-weekly depending on enrolled program; transferring to RN or LVN when necessary
- Empowering patients to follow up with their PCP, most often scheduling for them
- Coordinated and tracked transportation to and from medical appointments, ensuring adequate rides remain
- Ensuring that High Risk and discharged patients have all Durable Medical Equipment needed to move and transition safely
- Responsible for tracking order from PCP to distributor through to completion and delivery
- Ensuring that patients have food and necessary household supplies, submitting referrals and/or application for food delivery when needed.
Logistical Support Admin
Wellmed Medical Management
01.2019 - 05.2021
- Point of contact for Primary Care Physician, responsible for organizing in-office PSO Events, updating departmental calendar, communicated all changes to clinical and admin team
- Compiled and created excel spread sheets/call logs containing specific measures requiring collection for each provider’s WellMed panel of patients prior to PSO events
- Quality checking all necessary patient paperwork prior to event, ensuring it is prepared and provided in a timely manner for MA/NP team
- Collect and submit all clinical notes and patient results for closing quality gaps, reviewed and ensured proper closure of open measures; pulling completed Diabetic Eye Exam or lab results
- Systematized and delivered all PSO Event results to Physician Business Managers and/or Provider’s WellMed Champion within 2 weeks of event completion
- Responsible for maintaining accurate individual Audit Report, containing detailed patient information of measures required and addressed during PSO Appointment, for reporting purposes to Senior Management
- Confirming Telemed appointments with Medicare patients, and assisting them into virtual waiting rooms to meet with Nurse Practitioners
- Cross Training other admins and new Logistical Support Admins on creating accounts, rooming patients, and all other aspects of the LSA Role; crafted detailed SOP for the LSA Role.
Account Service Manager
Unitedhealthcare Medicare & Retirement
05.2016 - 01.2019
- Point of contact for Escalated member cases
- Investigate member and/or customer service issues as identified and communicate resolution to members within set amount of time
- Educating members on insurance benefits, premiums, and deductibles
- Concisely and accurately document member requests and interactions
- Pulling and listening to calls in Qfinity to determine plan or member error
- Assisting members in updating benefits, changes in Primary Care Physicians, etc
- Other duties, as assigned.
Customer Service Representative (SME)
OptumRx Pharmacy Svcs
10.2011 - 04.2016
- Accept incoming calls from customers, pharmacists, or providers on issues related to benefit eligibility questions and prescription status inquiries
- Educate customers on their prescription benefits, use of plan, formulary, premiums and status of orders and claims or inquiries
- Document required customer information in corresponding computer systems
- Identify issues, clearly communicate solutions and steps to customers, pharmacies, pharmacists, and physicians with prescription orders and resends
- Make outbound calls to customers on prescription orders and payment issues
- Take lead assist calls when needed
- Handling commercial High Touch clients’ accounts
- High Touch Team Subject Matter Expert, reviewed advocate calls and coached on quality when necessary
- Assisting with various assigned projects including facilitating new and existing employees.
Education
Lakewood Senior High School
Lakewood, CA06.1994
Skills
- Goal-oriented individual with professional attitude
- Highly motivated with extensive remote experience
- Excellent interpersonal and communicative skills
- Fluent in Healthcare and Pharmaceutical Benefits, HIPAA Compliance
Timeline
Pharmacy Benefit Specialist
TTEC Services
10.2023 - Current
Care Advocate
Wellmed Medical Management
05.2021 - 02.2023
Logistical Support Admin
Wellmed Medical Management
01.2019 - 05.2021
Account Service Manager
Unitedhealthcare Medicare & Retirement
05.2016 - 01.2019
Customer Service Representative (SME)
OptumRx Pharmacy Svcs
10.2011 - 04.2016
Lakewood Senior High School
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