Nicole Morgan

Experience

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  Restat- Pharmacy Benefit Manager

  Mar 2008 - Mar 2010

  Team Leader (Call Center)

  Resolved customer complaints and answered customers' questions regarding policies and procedures.• Reviewed records and reports pertaining to activities such as production, monitoring work activities, and evaluating performance.• Discussed job performance problems with employees to identify causes and issues and to work on resolving problems.

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  Wells Fargo Bank, N.A

  Oct 2010 - Aug 2011

  Senior Business Banker I (Call Center)

  Conferred daily with customers taking 100-150 inbound calls to provide information about products and services, cancel accounts, or to obtain details of complaints.• Checked to ensure that appropriate changes were made to resolve customers' problems and made 40 outbound calls daily to provide customers with investigation information.• Analyzed financial information obtained from clients to determine strategies for meeting clients' financial objectives.

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  Allstate

  Sept 2011 - Jun 2012

  Claims Specialist

  Provided employees guidance with handling difficult or complex problems and also lead and implemented trainings.• Reviewed policy terms to determine whether a particular loss or medical claim was covered by insurance.• Provided customer service, such as limited instructions on proceeding with claims or referrals to auto or medical facilities or local contractors.

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  AmerisourceBergen

  Nov 2012 - Jul 2017

  Responsibilities include but are not limited to: Effective time management, organizational skills, medicalcoding and billing, data entry, extensive payer research, payer tracking (Medicare, Medicaid, Tricare, andVarious Private Payers), benefit verifications (initial, subsequent, and re-verifications), ensuring maximumreimbursement and follow-up for the provider, obtaining accurate benefits in order to qualify patients for copayor patient assistance programs offered by the manufacturer, prior authorization and pre-determination initiationprocesses, reviewing medical policies (verbally or online) to ensure procedure acceptance, collaborating withpayers for specific processes in regards to medical procedures, assisting Site Coordinators with accuratebenefit information, payer processes, and payer research to ensure timely processing of enrollments, assistingwith Team Training and Knowledge Enhancement, Multi-Tasking, Voluntary Self-Improvement and Educationopportunities in order to enhance my knowledge and familiarity with Medicare, Medicaid, Tricare and variousprivate payer medical policies and guidelines, CPT and ICD-9 code additions and deletions with the assistanceof HCPCS, CPT, ICD-9 manuals, the internet, payer publications, and email alerts. Show less

  • Case Coordinator

    Jun 2015 - Jul 2017

  • Patient Care Coordinator

    Jul 2013 - Jun 2015

  • Benefits Verification Specialist

    Nov 2012 - Jul 2013
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  AllCare Plus Pharmacy

  Jul 2017 - Sept 2021

  Care Manager Remote
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  CareMetx, LLC

  Aug 2021 - now

  Care Manager Remote