Experience

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  Biogen

  Oct 2014 - May 2015

  Manager case management

  • Oversee and facilitate the customer lifecycle by assisting patients, healthcare providers and others with activities related starting and staying on medical therapy. • Strive to support people in managing their therapy when it comes to living with Multiple Sclerosis, Crohn’s Disease and Hemophilia.• Technical proficiency in a Customer Relationship Management System.Strong problem solving, maintain status of problem resolution and update customer on resolution status• Strong interpersonal skills in providing patient and healthcare provider support, understanding of medical benefit. FACETS Configuration daily.• Complied and adhered to HIPPA, PHI, PII and PCI standards during the execution of all engagements performed. Show less

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  Coram cvs/specialty infusion services

  Oct 2015 - Oct 2016

  Sr. patient intake coordinator & billing specialist

  • Managed and coordinated resource staffing, scheduling and status communications for all specialty infusions services, DME & ETF, IVIG.• Responsible for diagnosing, isolating and resolving complex issues and recommending and implementing strategies to resolve them• Accept and set up new patients for intravenous medications for ongoing care of life. Insurance follow up and payments.• Processes claims, bills and split claims.• Claims Adjudication - medical claims/bills for payment or denial.• Verify and relay insurance benefits and coverage for services. Work with ICD-9, ICD-10, HCPC, J-codes and CPT codes for services.• Educate patients and family members on medications, how to administer the medicine, Coram services and answer and questions. • Oversee and facilitate the customer lifecycle by assisting patients, healthcare providers and others with activities related starting and staying on medical therapy• Complied and adhered to HIPPA, PHI, PII and PCI standards during the execution of all engagements performed Show less

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  Piedmont cancer institute pc

  Oct 2016 - Sept 2017

  Billing treatment analyst

  • Financial analysis of COC (continuation of care) orders.• Process and Review account adjustments and write-offs, help patients establish budget payment plans, work closely with collection agency.• Claims Adjudication - medical claims/bills for payment or denial.• Contact insurance carriers for verification of coverage of drugs and procedures and whether or not pre-authorization, pre-certification or a referral is required.• Analyzing treatments for drug co-pay assistance and foundation assistance.• Speak with new chemotherapy patients to review benefits and make payment arrangements per policy.• Processes claims, bills and split claims.• Experienced in processing claims inpatient, outpatient, third party hospital and professional.• Request additional authorization approvals and denials. Working within Varain and Centricity databases.• Pend claims and resubmit claims.• Calculates manual adjustments if needed.• ICD-9, ICD-10, HCPC coding and billing Show less

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  Cencora | pharma solutions

  Sept 2017 - May 2022

  • Interacting with key stake holders within the physician practice or hospital outpatient locations. • Eliminating financial barriers by Providing Patient access to therapy. • 80% company travel, Experience working with HUB, Patient Services• Comprehensive understanding of Medicare Parts A, B, C, D and knowledge of commercial insurance reimbursement.• Facilitating live reimbursement training and education (group sizes vary) • Reviewing patient insurance benefit options for “Pull Through”• Validating prior authorization requirements • Identifying alternate funding/financial assistance programs (copay, foundation)• Assisting with resolving reimbursement issues/Specialty products( buy & bill) • Coordinating with our client’s patient support services programs representatives. • Educating physician office staff on the use of our client’s patient assistance and reimbursement support line services including web based provider programs. • Providing information on relevant reimbursement topics related to our client’s products. • Rheumatology, Oncology, Biologics, Osteoarthritis, Immunology• Understanding of the miscellaneous and permanent J code.• Strong knowledge of Specialty Pharmacy providers and relevant access dynamics Show less • Interacting with key stake holders within the physician practice or hospital outpatient locations. • Eliminating financial barriers by Providing Patient access to therapy. • 80% company travel, Experience working with HUB, Patient Services• Comprehensive understanding of Medicare Parts A, B, C, D and knowledge of commercial insurance reimbursement.• Facilitating live reimbursement training and education (group sizes vary) • Reviewing patient insurance benefit options for “Pull Through”• Validating prior authorization requirements • Identifying alternate funding/financial assistance programs (copay, foundation)• Assisting with resolving reimbursement issues/Specialty products( buy & bill) • Coordinating with our client’s patient support services programs representatives. • Educating physician office staff on the use of our client’s patient assistance and reimbursement support line services including web based provider programs. • Providing information on relevant reimbursement topics related to our client’s products. • Rheumatology, Oncology, Biologics, Osteoarthritis, Multiple Sclerosis.• Understanding of the miscellaneous and permanent J code.• Strong knowledge of Specialty Pharmacy providers and relevant access dynamics Show less

  • Assistant Director on behalf of Janssen Pharmacutical

    Jun 2021 - May 2022

  • Field Reimbursement Manager

    Sept 2017 - Jun 2021
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  Trialcard

  May 2022 - Dec 2024

  Senior regional manager

  • Help eliminate barriers for patients and increase their access to medications while working in an environment of collaboration. • Lead a team of 12 regionally aligned reimbursement managers and report to the Program Director. • Train, coach, develop and mentor the RMs so they provide the highest level of service to the HCP offices and patients on their therapeutic journey. • Assist with coaching and mentoring the Associate Regional Reimbursement Manager. • Train, coach, develop, and mentor a team of RMs Provide oversight and management of team performance to meet defined objectives. • Act as liaison between program management, client, and RM team Submit scheduled reports to the program manager regarding productivity statistics at both the team and employee level.• Solve complex patient access issues by working across the patient support program, and HCP offices and communicating with the client field team. • Partner with the sales team, marketing, HCPs, and pharmacies to create and drive strategic reimbursement support approaches, resulting in increased patient and market access Educate HCP and Office Staff on Patient Support Programs, per program-specific operating policies and patient journey.• Operate in Compliance with HIPAA within program guidelines Support the coaching and mentoring of the Associate Regional Reimbursement Manager Maintain expense reports for travel and in-office meetings. • Act as a Subject Matter Expert for HCPs and the patient support program on reimbursement and billing for their assigned region, utilizing all available resources, including Policy Reporter Work within TrialCard and client-designated systems to document interactions with HCPs. Show less

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  Johnson & johnson innovative medicine

  Dec 2024 - now

  Field reimbursement manager