Warren Lawrence
Summary
Health Insurance Professional with 20+ years of experience in customer service and 11 years of healthcare experience including pharmacy, health insurance benefits (Commercial, Medicaid & Medicare) as well as home healthcare. Seeking a position where I can use my expertise as well as gain new skills and help health plans grow.
Overview
19
19
years of professional experience
Work History
Senior Marketing Account Executive
Presbyterian Health Plan
Albuquerque, NM
07.2021 - 06.2026
- Collaborated with cross-functional teams to create effective promotional materials.
- Assisted clients with enrollment processes and provided service support inquiries.
- Facilitated training sessions for new staff on marketing tools and client management systems.
- Established strong relationships with clients to ensure their marketing goals were met.
- Maintained a comprehensive database of contacts related to current or potential customers.
- Coordinated with internal teams to ensure successful execution of campaigns.
- Organized promotional events such as conferences, workshops, and webinars aimed at increasing brand visibility.
- Managed client accounts by providing timely updates and resolving any issues promptly.
- Supervised creation of marketing materials and collateral.
- Cultivated business partnerships to build lasting relationships with internal and external parties.
Sales & Marketing Coordinator
Presbyterian Health Plan
Albuquerque, NM
07.2021 - Current
- Research pended application and work with beneficiaries and insurance agents to obtain missing information.
- Provide reporting for Medicare Sales department including reports for Medicare Groups (New Sales Report, LIS Report, Member Change Report, Rapid Disenrollment Report, FDR Report, Commercial and Centennial Age-Ins Report, Broker Enrollment Detail Report, AEP Daily Sales Report, Member Term Report).
- Research and provide responses to Medicare groups, internal and external agents and departments regarding enrollment issues, application status, benefit questions via phone and email.
- Assisted with the creation and implementation of Telephonic Enrollment Audit policy and conduct monthly audits for internal and external agents.
- Update and maintain plan information on company website.
- Train and couch new and existing agents on submitting applications using the online enrollment toll as well as the built in call recording function.
- Maintain and distribute leads to internal staff using Microsoft Teams.
- Closely work with large Medicare groups such as NMRHCA and UNM to resolve enrollment issue.
- Assist internal departments as well as external brokers regarding application and enrollment issues.
Scheduling Supervisor
Interim Home Healthcare
Albuquerque, NM
09.2019 - 10.2020
- Schedule and match clients with qualified home-care personnel to assist with daily living activities
- Review authorizations for services received from The Veterans Administration regarding patient authorized hours and plans of care for to ensure approved hours are utilized and plans of care are followed
- Review and approve visit documentation submitted by field staff
- Conduct quarterly reviews for field staff and provide frequent informal coaching
- Document all interactions with clients, caregivers, and referral sources via phone and electronic communication
- Ensures compliance with all federal, state and local government laws and regulations, as well as policies and procedures of the organization
- Train incoming field staff on scheduling and handbook policies as well as step by step instruction on the use of client documentation and interoffice communication applications.
Appeals and Grievance Coordinator
Western Sky Community Care
Albuquerque, NM
10.2018 - 09.2019
- Assist with successful implementation of the grievance and appeals process for a startup Medicaid health insurance plan
- Review internal workflows and processes to ensure all state and corporate guidelines are followed
- Provide training to incoming and existing customer service representatives on processes and requirements for accurate submission of appeals and grievances for members and providers
- Communicate with external medical professionals to request and obtain most recent patient clinical documents to ensure Medical Directors, pharmacist and review nurses have accurate information to perform a thorough appeal review of denied prior authorizations for medical services, medications and equipment
- Communicate resolutions of processed grievances and appeals to providers and members
- Maintain accurate log of all received appeals and grievance to cross reference with state report run by the department manager.
Customer Service Representative / Appeals & Grievance Research Specialist
Presbyterian Healthcare Services
Albuquerque, NM
10.2014 - 09.2018
- Answer provider and member calls to interpret/review benefits, claims and prior authorizations
- Research information using multiple systems, databases and internal documents to insure accurate information is provided
- Follow HIPAA guidelines to ensure patient information is protected
- Assisted as a dedicated representative on several specialty teams including; Broker services, Intel Connected Care, City of Albuquerque and Premium Payments.
Prescription Management Tech
ExcelleRx
Philadelphia, PA
12.2007 - 12.2013
- Review electronic and hard copy narcotic prescriptions to ensure accuracy and regulatory compliance.
- Assist department manager with storing and organizing hard copy and election prescription records for DEA (Drug Enforcement Agency) audits.
- Request missing information from providers offices to ensure we can fill prescription and ship medications to patients without delay.
- Train new and exciting employees on processes and workflows within the department.
- Assist pharmacist and pharmacy staff at fill site with filling and shipping medications based on prescriptions received to ensure the appropriate medication and quantity was dispensed.
- Complete monthly inventory checks to make sure all medications are fully accounted for.
- Perform rotation of all medications as new medications are received so no expired medications are dispensed.
Education
High School Diploma -
Dobbins/Randolph AVT High School
Philadelphia, PA06.2004
Skills
- Customer Service
- Multitasking
- Client Relations
- Policy and Procedure Implementation
- Documentation Skills
- Data Entry
- Organizational Skills
- Exceptional Phone Etiquette
- Verbal and Written
- Communication Skills
- Microsoft Office (Word, Excel, Power Point, Teams)
Additional Information
- Licensed Insurance Producer: Life, Accident and Health or Sickness NPN 19927105
Timeline
Senior Marketing Account Executive
Presbyterian Health Plan
07.2021 - 06.2026
Sales & Marketing Coordinator
Presbyterian Health Plan
07.2021 - Current
Scheduling Supervisor
Interim Home Healthcare
09.2019 - 10.2020
Appeals and Grievance Coordinator
Western Sky Community Care
10.2018 - 09.2019
Customer Service Representative / Appeals & Grievance Research Specialist
Presbyterian Healthcare Services
10.2014 - 09.2018
Prescription Management Tech
ExcelleRx
12.2007 - 12.2013
High School Diploma -
Dobbins/Randolph AVT High School