Experience

Biologics by McKesson

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Patient Support Case Manager

  • Mar 2021 - Present

  • Single point of contact with the Practice Support Liaison to review daily reporting and adhere to practice preferences for referral processing.• Create a patient profile using the demographics provided by the provider.• Overcome payor hurdles by initiating overrides, process prior authorizations, verify benefits and network coordination.• Overcome financial barriers by utilizing manufacturer and foundational assistance programs.• Keeping consistent and accurate communication with medical doctor’s offices regarding status of patient orders through management of a fluid excel spreadsheet, phone, fax and/or email.• Coordinate and manage HCP relationship from onboarding into the myPAS program to dispense, whether with IOD, Biologics by McKesson, MID or another pharmacy.• Assist with onboarding presentation to new potential MID’s using PowerPoint • Create SOP as new procedures and programs are newly designed • Process and verify monthly billing invoices for services rendered to the doctor’s offices Show less

• Patient Assistance Specialist

  • Nov 2018 - Mar 2021

  • Confirm the accuracy of patient insurance information to complete the insurance verification process.• Communicate with providers regarding patient updates; document in the Management Information System to allow team members to quickly assess the status of the patient’s referral.• Communicate, when applicable, with patients regarding their pharmacy benefit coverage and out of pocket responsibilities.• Facilitate prior authorization with insurance companies for customer receiving same-day shipments.• Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to eliminate team members having to place additional phone calls to patients.• Contact patients to assist with obtaining co-pay assistance programs for new enrollments and verification through different foundations and manufactures.• Processing live claims through patient’s insurance to obtain copay amounts Show less



TrialCard

• United States
• Pharmaceutical Manufacturing
• 500 - 600 Employee

• Patient Care Coordinator

  • Apr 2017 - Nov 2018

  • Liaison between Program Management, Healthcare Providers and Manufacturer • Regionally aligned and serve as an expert on reimbursement, co-pay, foundation assistance and PAP issues and be responsible for handling patient and healthcare provider interactions • Serve as an advocate to patients regarding program enrollment, reimbursement process, affordability support and general access for prescribed therapy • Serves as direct point of contact to assigned health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient • Partner with the prescriber and patient to remove all non-clinical barriers to patient access to prescribed therapy • Maintains records in accordance with applicable standards and regulations to the programs/promotions • Establish relationships, develop trust, and maintain rapport with patients and healthcare providers. Show less



CVS/Caremark

• United States
• Wellness and Fitness Services
• 700 & Above Employee

• Senior Team Resolution Specialist

  • Jul 2014 - Apr 2017

  • Responds to Medicare inquiries and complaints using standard scripts and procedures. • Act as a subject matter expert to provide functional guidance, training, support and assistance to lower-level staff. • Monitors priority of calls and shifts escalated calls to assure resolution of problems. • Gathers information, research/resolves inquiries and logs customer calls. • Process claims while assisting Pharmacist/Pharmacy Tech with overrides. • Send, receive and document messages between doctors and patients. • Receive and post payments to patient accounts. • Familiarity with HIPPA privacy requirements when interacting with patients and third-party callers. • Fax forms and refill request, request and fill out forms related to insurance billing. Show less