Álýška Hilty

Senior Adjudication Technician & A/R at Young at Heart Pharmacy
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Contact Information
us****@****om
(386) 825-5501
Location
Fishers, Indiana, United States, IN
Languages
  • Basic Spanish -

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Credentials

  • Pharmacy Technician
    Indiana Board of Pharmacy
    Nov, 2021
    - Oct, 2024
  • DODD
    State of Ohio - Department of Developmental Disabilities
    Feb, 2016
    - Oct, 2024

Experience

  • Young at Heart Pharmacy
    • United States
    • Health, Wellness & Fitness
    • 1 - 100 Employee
    • Senior Adjudication Technician & A/R
      • Jan 2021 - Present

      • Responsible for adjudication and resolution of rejected third party claims for Medicare, Medicaid, & commercial insurance. • Passionate trainer/coach for new and existing staff. • Efficient working of prior authorizations & implementation of updated prior authorization process resulting in smaller volume of prior authorization queue & faster turnaround time. • Medicare, Medicaid, & commercial insurance verification & eligibility. • Creating and running billing for end of month. • Account Receivable resolutions & creation of collections processes. • Volunteers for monthly weekends on-call & assists data entry keying orders PRN. • Proficient with Framework & Docutrack. Show less

  • PharmScript LLC
    • United States
    • Pharmaceutical Manufacturing
    • 700 & Above Employee
    • Facility Revenue Billing Specialist
      • Jun 2020 - Dec 2020

      • Responsible for pharmacy billing for 12 facilities across 6 states. • Daily Census including Admissions, Discharges, & Payor changes. • Electronic submission of pharmacy claims. • Medicare, Medicaid, & commercial insurance verification & eligibility. • Dispute Resolutions. • Account Receivable resolutions. • Proficient with Framework, Docutrack, & Point Click Care. • Responsible for pharmacy billing for 12 facilities across 6 states. • Daily Census including Admissions, Discharges, & Payor changes. • Electronic submission of pharmacy claims. • Medicare, Medicaid, & commercial insurance verification & eligibility. • Dispute Resolutions. • Account Receivable resolutions. • Proficient with Framework, Docutrack, & Point Click Care.

  • Kroger
    • Germany
    • 1 - 100 Employee
    • Starbucks Department Head
      • Oct 2019 - Jun 2020

      • Responsible for conducting business analysis and driving sales. • Coached and Trained new and existing staff. • Ensured all standards and procedures for Starbucks were followed and up to health codes. • Inventory management including supply and food ordering. • Labor forecasting and scheduling. • Responsible for conducting business analysis and driving sales. • Coached and Trained new and existing staff. • Ensured all standards and procedures for Starbucks were followed and up to health codes. • Inventory management including supply and food ordering. • Labor forecasting and scheduling.

  • CHICAGO PEDIATRIC THERAPY & WELLNESS CENTER, LLC
    • United States
    • Health, Wellness & Fitness
    • 1 - 100 Employee
    • Medical Billing Specialist
      • Jan 2018 - May 2018

      • Reviewed and resolved rejected insurance claims. • EMR management of patient charts in RainTree. • Insurance electronic and paper claim submission. • Built and utilized custom reports to increase practice efficiency. • Credentialed practice clinicians in IL. • Reviewed and resolved rejected insurance claims. • EMR management of patient charts in RainTree. • Insurance electronic and paper claim submission. • Built and utilized custom reports to increase practice efficiency. • Credentialed practice clinicians in IL.

  • Cushman & Wakefield
    • United States
    • Real Estate
    • 1 - 100 Employee
    • Office Coordinator & Analyst
      • Jul 2016 - Jun 2017

      • Oversaw global and regional contract processing for Global Technology Solutions (GTS). • Created and maintained custom reports and analytics in Excel and Power Point. • Direct liaison to global and regional Chief Executives and directors regarding creation and execution of contracts and purchase orders. • Verified budget allocation for contract requests. • Processed invoices and tracked payment status. • Successful problem resolution and improvement with Business Operations team. • Trained new business analysts. Show less

  • Hope Tree Care LLC.
    • United States
    • Medical Practices
    • 1 - 100 Employee
    • Administrative Assistant
      • Feb 2016 - Jul 2016

      • Organized and maintained patient charts, medical files, and employee files. • Coordinated patient care. • Assisted in hiring, training, and onboarding of new staff. • Aided in problem solving and increased business efficiency. • Represented executive in executive’s absence. • Conducted research, compiled data, and generated reports. • Provided direct care coverage in case of emergency. • Coordinated executives’ schedules. • Transcribed notes and meeting minutes. • Organized and maintained patient charts, medical files, and employee files. • Coordinated patient care. • Assisted in hiring, training, and onboarding of new staff. • Aided in problem solving and increased business efficiency. • Represented executive in executive’s absence. • Conducted research, compiled data, and generated reports. • Provided direct care coverage in case of emergency. • Coordinated executives’ schedules. • Transcribed notes and meeting minutes.

  • Home Care by Black Stone, an Almost Family company
    • United States
    • Hospitals and Health Care
    • 100 - 200 Employee
    • Therapy Administrative Assistant
      • Apr 2015 - Feb 2016

      • Responsible for contract PT, OT, and ST in Cincinnati, OH and Dayton, OH. • Ran reports and notified appropriate parties. • Conducted first round interviews for hiring process. • Verified and processed invoices for contract therapy. • Data entry of contract therapy, staff notes and evaluations including VFOs, goals, interventions, OASISs and clinical summaries. • Covered for therapy manager when absent. • Team-based problem solving and process improvement. • Proficient in Health Wyse and All Scripts. Medical & Patient Show less

  • Hand Rehabilitation & Orthotic Specialists
    • Medical Coordinator, Patient Coordinator, Credentialist, & Clinic Assistant
      • Oct 2013 - Apr 2015

      • Handled new patient intake and chart management. • Obtained insurance benefits and prior authorizations. • Submitted C9’s for worker’s compensation. • Managed research and resolution of non-payments on insurance claims. • Credentialed the practices & providers. • Cost effectively handled medical supply inventory and ordering. • Handled legal requests. • Assisted in patient setup for therapy as well as in custom casting and splinting. • Trained new employees. • Proficient in WebPT. Show less

Education

  • Indiana State University - School of Business
    Bachelor’s Degree, Marketing

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