Valencia Mitchell
Reimbursement Coordinator
Zion,IL
Summary
Seeking a full-time position that offers professional challenges that utilize interpersonal skills, time management and problem-solving. Excellent with communication, judgement, and adapting new situations and challenges to best enhance the organizational brand.
Overview
14
14
years of professional experience
Work History
Access and Reimbursement Case Coordinator
AbbVie
09.2018 - Current
- Proactively monitored the status of patient cases & identified discrepancies that hindered access, leading to a reduction in average case resolution time by 35%.
- Handled New Products launches with challenging Market Access issues with non-formulary restrictions under policy review for new medications
- Facilitated communication between key stakeholders to ensure successful administration of Patient Support Service Programs, resulting in 100% program completion rate.
- Coordinated with over 250 Healthcare Providers and Insurance companies monthly to provide timely reimbursement support for 300+ patients on AbbVie's programs, improving cost savings by 15%.
- Successfully resolved cases involving access & reimbursement issues within a timely manner to increasing case resolution rates.
- Collaborated with 10 cross-functional stakeholders to review & update existing program documentation to ensure accuracy & compliance with regulatory standards.
Reimbursement Analyst
Abbvie
08.2013 - 09.2018
- Analyzed insurance verification/coverage data to identify cost savings opportunities and facilitate coverage authorization requests, leading to a reduction in appeals filing costs.
- Investigated pharmacy and medical benefits for over 500 patients, resulting in a successful reimbursement rate.
- Determine the patient’s financial responsibilities, quantity limits, prior authorizations, and pre-certifications requirements.
- Resolved complex cases by utilizing advanced problem-solving techniques, resulting in a 90% resolution rate within one week.
- Coordinate with other departments to assure timely claim payments.
- Accurately transmit test claims to verify prescription coverage.
Insurance Biller
Midwestern Regional Hospital
12.2008 - 08.2013
- Identified discrepancies in insurance information for 10% of patients, saving the organization an estimated $100K annually.
- Coded over 5,000 patient records using ICD-9 and CPT/HCPS codes to ensure the accuracy of claims for reimbursement.
- Executed timely account reconciliations on average 2 days ahead of schedule, increasing customer satisfaction by 40%.
- Established quality control measures resulting in a decrease in customer complaints related to billing errors.
- Spearheaded a comprehensive review of medical insurance billing practices to streamline processes and reduce rejections by 25%. Proficient in A/R, billing, and DEP applications including the printing of appropriate reports.
- Familiar with various types of medical plans and knowledge of client plan provisions.
Education
Master of Science - Industrial And Organizational Psychology
National Louis University
Chicago, ILBachelor of Arts - Human Services
Columbia College of Lake County
Lake County, ILAssociate of Applied Science - General Studies
Columbia College of Lake County
Lake County, ILSkills
- COMPUTER SKILLS
- Microsoft Office Salesforce Script Med Microsoft Outlook Windows XP Market Access
- Change Healthcare Medicare/Medicaid AMPFM Remy Rx Valet
- Information Updates
- Critical Thinking
- Case Coordination
- Clinical Data Collection
- Compliance Requirements
- Client Satisfaction
- Case Planning and Management
Quote
Grant me the serenity to accept the thing I cannot change, the courage to change the things I can, and the wisdom to know the difference.
Unknown
Timeline
Access and Reimbursement Case Coordinator
AbbVie
09.2018 - Current
Reimbursement Analyst
Abbvie
08.2013 - 09.2018
Insurance Biller
Midwestern Regional Hospital
12.2008 - 08.2013
Master of Science - Industrial And Organizational Psychology
National Louis University
Bachelor of Arts - Human Services
Columbia College of Lake County
Associate of Applied Science - General Studies
Columbia College of Lake County
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