Yehudah M. Clark
Tampa,Florida
Overview
15
15
years of professional experience
Work History
Health Insurance Agent
Tranzact
07.2023 - 02.2025
- Presenting products and programs to potential prospects, including Medicare Advantage, Medicare Supplements and Prescription Drug Plans
- Helping people get into the best possible coverage for their needs
- Assisted in the underwriting process prospect beneficiaries with chronic special needs
- Work closely with other Medicare health insurance professionals to help ensure beneficiary satisfaction receives all entitled benefits within Medicare
Front Desk/Billing Clerk
Anderson & Chaabra Eyecare Center
Tampa, Florida
05.2022 - 02.2023
- Multiple office duties including insurance verification, fax/copy scanning, answering phones and scheduling patient appointments
- Filed claims for medical and vision insurance plans
- Front desk check in/out and collecting patient co-pays
Accounts Receivable
Florida Wellness Medical Group
Tampa, Florida
03.2022 - 05.2022
- Filed PIP insurance claims for patients involved in auto accidents, workman's comp & primary care visits
- Appropriated massage and acupuncture monthly membership fees to the patient's chart for credit
- Reviewed EOB's and ERA's to determine claim status and outreach to the insurance adjuster for any discrepancies involving payment
- Entered non-claim charges in the billing software for services not covered by the patients' insurance
- Outreach to attorneys to negotiate settlement offers on an outstanding balance
Patient Care Specialist
Tampa Family Health Center
Tampa, Florida
01.2020 - 02.2022
- Scheduled appointments to facilitate the efficient running of the office
- Obtain proof of insurance and schedule patient appointments; reschedule appointments
- Received internal training through employer through various accreditation agencies, HIPAA, State and local rules and regulations
- Verify and update patient information in the electronic health record
- Answer and manage all inbound and outbound calls from providers, case managers
Prior Authorizations Specialist
Aetna (US Tech Solutions Staffing Inc)
Jersey City, NJ
11.2018 - 03.2019
- Conducted prior authorization reviews for Aetna Medicare members with Part B and D coverage plans
- Maintained compliance through CMS compliance training modules to adhere to Medicare guidelines
- Received daily initiatives designed to facilitate streamlined processes for faster reviews
- Contacted providers, members, pharmacies, POA's, to render fair and timely reviews in accordance with Medicare rules
- Relocated to Tampa, FL
Registered Pharmacy Technician
Walgreens Corporate - Miami Lakes, FL (PBM)
Miami Lakes, FL
05.2017 - 08.2018
- Handled 150+ inbound and outbound calls refilling prescriptions for patients Walgreens retail, mail order, and online pharmacies
- Coordinated with prescribers and insurances for RX renewals and Prior Authorizations
- Answered calls regarding Medicaid, Medicare Part B and D, commercial patient regarding prescription status
- Provided support for Walgreens.com to ensure easy online pharmacy access for consumers
- Assisted pharmacists in local retail stores including competitors with RX transfers
- Maintained compliance with HIPAA via employee training modules
Medical Claims Processor
Intermedix
Miami Lakes, Fl
05.2015 - 05.2017
- Determine patients eligibility Medicaid and Availity portals
- Billed ambulatory services in various counties within the state of FL both electronically & the CMS-1500 form
- Worked pre-collections reports to determine if patient accounts were eligible for collections
- Corrected billing erratum i.e., bad addresses, patient demographics, and COB errors
- Filed appeal letters to dispute billing debts on behalf of transport patients
- Post payments, adjustments and notes from EOBs
- Reconcile electronic remittance notices
Medicare Benefits Specialist
Convergys Corporation
Denver, CO
05.2010 - 10.2014
- Provided contact support for centers of Medicare and Medicaid through Palmetto GBA, one of the world's largest Medicare contractors
- Managed inquiries for beneficiaries through 1(800)-Medicare with questions pertaining to coverage, upcoming Medicare changes, prescription drugs and pharmaceuticals
- Administered health insurance claims for millions of Americans, which included HMOs, PPOs, SSD and Railroad Retirement Board benefits
- Provided superior customer service for companies such as Well-Care, Humana, Blue Cross Blue Shield as well as Medicare supplemental insurances
- Ordered prescription drugs, diabetic testing supplies, durable medical equipment and scheduled appointments for preventative services in inpatient/outpatient facilities
Education
Miami Central Senior High School
Miami, FL2001
Skills
2-40 Health Insurance License
6-20 Acredited Claims Adjuster
Training
- Accredited Claims Adjuster (Current)
- Licensed Health Insurance Agent (Current)
- Registered Medical Coder (Former)
- Registered Pharmacy Technician (Former)
Timeline
Health Insurance Agent
Tranzact
07.2023 - 02.2025
Front Desk/Billing Clerk
Anderson & Chaabra Eyecare Center
05.2022 - 02.2023
Accounts Receivable
Florida Wellness Medical Group
03.2022 - 05.2022
Patient Care Specialist
Tampa Family Health Center
01.2020 - 02.2022
Prior Authorizations Specialist
Aetna (US Tech Solutions Staffing Inc)
11.2018 - 03.2019
Registered Pharmacy Technician
Walgreens Corporate - Miami Lakes, FL (PBM)
05.2017 - 08.2018
Medical Claims Processor
Intermedix
05.2015 - 05.2017
Medicare Benefits Specialist
Convergys Corporation
05.2010 - 10.2014
Miami Central Senior High School