17606 Lindstrom Court, Gaithersburg, MD 20877 Mobile: xxx-xxx-xxxx xxx-xxx-xxxx
Reimbursement Counselor background working with pharmaceutical and health insurance companies. Effective communication ability with medical community and patients resulted in special project assignments. Received six performance-based monetary awards during 2015 to 2017.
Lash Group Rockville, MD
Patient Access Specialist/January 2018-August 2019 HRS 40/wk
Managed the Prolia® program for patients diagnosed with Osteoporosis. Interacted with health insurance companies (e.g., Aetna, United Health Care, Blue Cross Blue Shield) to obtain pharmacy benefits for patients to include co-pays, out-of-pocket expenses, and prior authorizations. Addressed general inquiries from the medical community (e.g., physicians, nurses, and patients) such as status of completion of benefits, review of summary of benefits to clarify information, and denial of claims and recommendations for claims resolution; faxed documents to medical offices. Followed telephone call scripts to obtain information and entered into Patient Plus database. Placed calls to follow up on prior authorizations, appeals, and claims. Trained new hires. Attended annual meetings held in Arundel County, MD. Worked remotely from July 2018 to August 2019. Referred patients to copay assistance programs. Knowledge of medical terminology.
Amerisourcebergen Rockville, MD
Reimbursement Counselor/November 2014-December 2017 HRS 40/wk
Managed the Gilenya® program for patients diagnosed with Multiple Sclerosis. Communicated with health insurance companies (e.g., Aetna, United Health Care, Blue Cross Blue Shield) to obtain pharmacy benefits for patients, which included co-pays, out-of-pocket costs, and prior authorizations. Followed telephone call scripts to gather information and entered data into payer-coverage history screen. Placed follow-up calls on prior authorizations and appeals. Selected to test the pilot system Theracall benefits database. Trained 30 temporary employees in a classroom setting during the 2015-16 reverification season; provided individual training for new permanent hires. Triage patients to PAP
Amerisourcebergen Special Project Assignments
Reimbursement Counselor/May-July 2017
Appointed to manage the Dupixent® program for patients diagnosed with Eczema. Reimbursement counselor duties involved direct work with health insurance companies.
Senior Reimbursement Counselor/November 2016-January 2017
Assigned as a temporary Senior Reimbursement Counselor to manage the Gleevec® program for patients diagnosed with Leukemia. Conducted follow-up calls to patients; interacted with nurses, pharmacists, and Federal and State social workers about patient medications. Recommended co-pay assistance for patients who required financial support for co-pay expenses who met eligibility requirements. Processed new prescriptions into system to initiate benefit investigation process.
Covance Gaithersburg, MD
Medical Call Center Representative/Program Specialist/November 2012-February 2013
Verified health benefits for patients diagnosed with Rheumatoid Arthritis. Followed a telephone script to obtain information and entered into Siebel program system. Placed follow-up calls to ensure accuracy in data; conducted periodic data clean up in Siebel to ensure accuracy in patient and provider information. Prepared patient mailings. Conducted annual re-verifications of benefits. Knowledge of medical terminology.
Quality First Imaging Gaithersburg, MD
Document Imaging Clerk/November 2008-November 2010 HRS 40/wk
Received incoming data from Verizon Wireless customers nationwide; sorted according to refunds, electronic signatures, and account invoices. Maintained data files of handwritten signatures; shredded extraneous documents. Scanned information for uploading to Verizon Wireless database, which enabled customers to view online accounts. Reviewed invoices and completed prep work for City of Rockville.
Asbury Methodist Village Gaithersburg, MD
Part-time Receptionist/August 2006-June 2008
Received incoming calls; placed telephonic requests for work orders and staff, such as building engineers, security, and housekeeping. Assisted residents and updated healthcare information. Created admission brochures for upcoming marketing events.
Kirkegaard & Perry Lab, Inc. Gaithersburg, MD
File Clerk/June 2006. HRS 40/wk
Filed documents according to city, state, and zip codes categories. Processed data in document control department by scanning documents, retrieving and reviewing lab files to determine legibility of content.
Westat Rockville, MD
Survey Processing Support Staff/October 2004-January 2005
Received and mailed packages using FedEx carrier; sorted incoming mail. Photocopied, filed, and faxed documents. Affixed barcodes on documents for subsequent scanning.
Magruder High School; Rockville, MD
Diploma, June 2002
Montgomery College; Rockville, MD
Coursework in Computer Graphics/Web Design
MS Office: Word, PowerPoint, Excel, Outlook; Siebel/Oracle
Internet Explorer, Theracall, Patient Plus
Receptionist, office assistant, file clerk