Experience

ACE Rent A Car

• United States
• Travel Arrangements
• 1 - 100 Employee

• Customer Experience Specialist

  • sept. de 2021 - - actualidad



PharmaScript Ambulatory Infusion Center

• Wellness and Fitness Services

• Customer Relations Specialist

  • ago. de 2019 - jul. de 2020

  Review referrals to make sure clinic notes are up to date and corresponding to medication requested and meets medical necessity. Obtain prior authorizations. Schedule patients around availability of the nurses. Discuss benefit coverage. Monitor inventory and usage. Handle replenishment and documentations. Assist with filing of correspondence or clinical documentation. Respond to inquiry calls from applicants or potential clients. Perform in compliance with company policies and procedures and professionals and community standards. Maintain client, employee, and agency confidentiality in all aspects of the job. Report all client concerns to Clinical Supervisor immediately. Train and support nurses and pharmacists in all areas of understanding healthcare insurances, organizational structures within the company, facilitate participation in event coordinating, fundraising, brainstorm different ways of marketing and promoting the company from team members.



HME Specialists, LLC

• Infusion Intake Coordinator

  • jul. de 2016 - ago. de 2019

  Data entry, insurance verification, coordination of benefits, obtaining home infusion benefits, specialty drug benefits, enteral benefits, out of pocket expenses, co-pays, co-insurance's, submitting pre-authorization's for home infusion/ambulatory infusion services, correct calculation of HCPC units and nursing visits, medically necessary diagnosis/ICD-9 and ICD-10 coding. Clinical communication with medical staff e.g., case managers, nurses, doctors, home health agencies, ensuring patient safety and deliverance of quality care. Professional and personal experience with patient’s and or with their family members. HIPAA compliant. Coordinate shipping and receiving of medications. Utilizing my Spanish speaking skills to assist nurses on teaches done at the hospital or home of patient’s who do not speak English. Transcription of English forms into Spanish language. Scheduling of in-suite infusions. Communication with health insurance providers to inquire about claims and denials. Attend daily morning meetings surrounding current patients, attend monthly operational meetings. Assist with special projects, create efficiency in the workplace. Assist different departments to alleviate hold times, increasing client satisfaction.



Presbyterian Healthcare Services

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Health Insurance Specialist

  • ene. de 2015 - jul. de 2016

  Answering phone calls within 5 seconds, listen attentively to know exactly what the members need, explaining basic health insurance such as; co-insurances, copay's, deductibles, Out-of-pocket, etc. Quoting precise health benefits, walk-through’s through websites, determining contracted providers, establish members with primary care providers, extreme analytical skills to determine premium payments, and claims. Contacting providers for members to meet desired resolutions. Answering phone calls within 5 seconds, listen attentively to know exactly what the members need, explaining basic health insurance such as; co-insurances, copay's, deductibles, Out-of-pocket, etc. Quoting precise health benefits, walk-through’s through websites, determining contracted providers, establish members with primary care providers, extreme analytical skills to determine premium payments, and claims. Contacting providers for members to meet desired resolutions.