Experience

Mercalis

• United States
• Pharmaceutical Manufacturing
• 100 - 200 Employee

• Solutions Delivery Specialist

  • Oct 2022 - Present

• Team Lead

  • Nov 2018 - Present

  • Leads a team of processors responsible for assigning and processing Explanation of Benefits (EOBs) for various programs • Rectifies EOB processing concerns such as but not limited to customer inquiries regarding reimbursement amount, EOB calculations, system errors in processing, etc. • First line of escalation • Monitor schedule adherence and address deviations immediately • Provides instruction and guidance to the Team • Report AEs, PQCs and MIs discovered via USPS… Show more • Leads a team of processors responsible for assigning and processing Explanation of Benefits (EOBs) for various programs • Rectifies EOB processing concerns such as but not limited to customer inquiries regarding reimbursement amount, EOB calculations, system errors in processing, etc. • First line of escalation • Monitor schedule adherence and address deviations immediately • Provides instruction and guidance to the Team • Report AEs, PQCs and MIs discovered via USPS mail • Check investigations (reprints, voids) • Assists the PEC with rebate related inquiries • Monitors workload daily and adjusts priorities to ensure service levels are met per the Client’s specifications • Supervises on the job training for processing • Facilitates all aspects of the process set forth by a Client via SOPs for Exception requests submitted by a customer • Provides feedback and direction to the team and individuals when needed regarding performance • Ensures processors are working diligently with tasks and addresses any concerns regarding productivity • Serves as a role model to the team encouraging teamwork and professionalism • Assists in duties of Program Associate when necessary • Performs a variety of tasks as assigned by the Processing Manager

• Program Associate

  • Nov 2017 - Nov 2018

  • Enter data into specific computer programs with accuracy and in a timely manner. • Review and analyze documents to determine appropriate processing procedure • Assign various document types to the appropriate accounts • Ability to recognize and report information as required by a client (i.e., Adverse Events) • Process Explanation of Benefit (EOB) statements for various programs • Communicate with the leadership team on escalation trends. • Perform specific tasks related… Show more • Enter data into specific computer programs with accuracy and in a timely manner. • Review and analyze documents to determine appropriate processing procedure • Assign various document types to the appropriate accounts • Ability to recognize and report information as required by a client (i.e., Adverse Events) • Process Explanation of Benefit (EOB) statements for various programs • Communicate with the leadership team on escalation trends. • Perform specific tasks related to program requirements

• Patient Experience Specialist

  • Nov 2015 - Nov 2017

  • Manage large amounts of inbound calls in a professional, polite and timely manner. • Building and engaging relationships with callers by going the extra mile. • Keep records of callers interactions, recording details of inquiries, complaints or comments, as well as actions taken. • Identifying callers needs by clarifying information, and resolving issues by researching, exploring alternate solutions and escalating when needed. • Check to ensure that appropriate changes were made… Show more • Manage large amounts of inbound calls in a professional, polite and timely manner. • Building and engaging relationships with callers by going the extra mile. • Keep records of callers interactions, recording details of inquiries, complaints or comments, as well as actions taken. • Identifying callers needs by clarifying information, and resolving issues by researching, exploring alternate solutions and escalating when needed. • Check to ensure that appropriate changes were made to resolve callers' problems. • Correctly identifying and reporting adverse events, medical inquiries, product complaints and high dose alerts. • Simple claims processing. • Making outbound calls



Sears

• United States
• Retail
• 700 & Above Employee

• Router and Dispatcher

  • Jul 2014 - Nov 2015

  Same Day Router • Made outbound calls to customers to reschedule services and to provide technicians arrival time. • Moved calls on technicians routes to create a more productive and efficient route. • Contacted customers to offer sooner repair service. Next Day Router • Worked directly with technician managers to build and map routes. • Determined schedules, sequences, and assignments for work activities, based on work priority, quantity of equipment, and skill of… Show more Same Day Router • Made outbound calls to customers to reschedule services and to provide technicians arrival time. • Moved calls on technicians routes to create a more productive and efficient route. • Contacted customers to offer sooner repair service. Next Day Router • Worked directly with technician managers to build and map routes. • Determined schedules, sequences, and assignments for work activities, based on work priority, quantity of equipment, and skill of personnel. • Shifted technicians’ local knowledge to other areas throughout the state to maximize service completions. • Contacted escalated customers with unresolved repair issues to move up service appointments. Show less Same Day Router • Made outbound calls to customers to reschedule services and to provide technicians arrival time. • Moved calls on technicians routes to create a more productive and efficient route. • Contacted customers to offer sooner repair service. Next Day Router • Worked directly with technician managers to build and map routes. • Determined schedules, sequences, and assignments for work activities, based on work priority, quantity of equipment, and skill of… Show more Same Day Router • Made outbound calls to customers to reschedule services and to provide technicians arrival time. • Moved calls on technicians routes to create a more productive and efficient route. • Contacted customers to offer sooner repair service. Next Day Router • Worked directly with technician managers to build and map routes. • Determined schedules, sequences, and assignments for work activities, based on work priority, quantity of equipment, and skill of personnel. • Shifted technicians’ local knowledge to other areas throughout the state to maximize service completions. • Contacted escalated customers with unresolved repair issues to move up service appointments. Show less



7236 Medical Support Unit, US Army Reserves

• Ft. Bragg, NC

• Dental Assistant

  • Feb 2007 - Feb 2015

  • Recorded medical and dental histories and vital signs of patients and record treatment information in patient records. Assist dentist during dental procedures and instruct patients in oral hygiene and plaque control programs. • Prepared patient, sterilize or disinfect instruments, clean and polish removable appliances, set up instrument trays, prepare materials. • Proficient at Land Navigation • Weapons training and qualification • Practiced medical procedures • Recorded medical and dental histories and vital signs of patients and record treatment information in patient records. Assist dentist during dental procedures and instruct patients in oral hygiene and plaque control programs. • Prepared patient, sterilize or disinfect instruments, clean and polish removable appliances, set up instrument trays, prepare materials. • Proficient at Land Navigation • Weapons training and qualification • Practiced medical procedures



RTI International

• United States
• Research Services
• 700 & Above Employee

• Tracer/Telephone Interviewer

  • Mar 2011 - Oct 2012

  • Searched computer databases, credit reports, public records, tax or legal filings, and other resources to locate persons. • Called patients to update account information. • Conducted health surveys and collect data. • Searched computer databases, credit reports, public records, tax or legal filings, and other resources to locate persons. • Called patients to update account information. • Conducted health surveys and collect data.



hhgregg

• United States
• Retail
• 700 & Above Employee

• Customer Service Merchandiser

  • Jun 2010 - Oct 2010

  • Greeted customers entering the establishment in a polite and professional manner. • Assisted customers by answering questions, providing information and resolving issues. • Received payment by cash, check or credit cards and issue receipts, refunds, credits, or change due to customers. • Processed merchandise returns and exchanges. • Calculated total payments received during a time period, and reconcile this with total sales. • Maintained clean and orderly checkout areas and… Show more • Greeted customers entering the establishment in a polite and professional manner. • Assisted customers by answering questions, providing information and resolving issues. • Received payment by cash, check or credit cards and issue receipts, refunds, credits, or change due to customers. • Processed merchandise returns and exchanges. • Calculated total payments received during a time period, and reconcile this with total sales. • Maintained clean and orderly checkout areas and complete other general cleaning duties. Show less • Greeted customers entering the establishment in a polite and professional manner. • Assisted customers by answering questions, providing information and resolving issues. • Received payment by cash, check or credit cards and issue receipts, refunds, credits, or change due to customers. • Processed merchandise returns and exchanges. • Calculated total payments received during a time period, and reconcile this with total sales. • Maintained clean and orderly checkout areas and… Show more • Greeted customers entering the establishment in a polite and professional manner. • Assisted customers by answering questions, providing information and resolving issues. • Received payment by cash, check or credit cards and issue receipts, refunds, credits, or change due to customers. • Processed merchandise returns and exchanges. • Calculated total payments received during a time period, and reconcile this with total sales. • Maintained clean and orderly checkout areas and complete other general cleaning duties. Show less