Reimbursement specialist Resume

SUMMARY:

A professional with more than four years of client facing experience in pharmaceuticals and IT. Skilled in working with programs to develop and execute actionable plans that link to program’s vision. Currently seeking an opportunity where I can provide value added services in health and/or IT.

TECHNICAL SKILLS:

MS Word, MS Visio, MS Excel, MS PowerPoint, MS Access, VMware applications, LAN & VPN/Remote Connectivity, TCP/IP, Windows, Unix, NetWare Servers, Citrix, ICD - 9 and ICD-10

EXPERIENCE:

Reimbursement specialist

Confidential

Responsibilities:

Provided assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
Perform intake of cases and capture all relevant information in Case Management system
Ensure all support requested is captured within the Case Management system
Ensure timely processing and resolution of cases
Escalate cases appropriately to the Patient Access Associate team
Coordinate all appropriate aspects of patient case management through to completion, using effective interpersonal skills to manage interactions
Serve as a resource for Health Care Providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for complex patient access situations, working closely with the PAA team to appropriately escalate/resolve issues
Communicate effectively with payers, third party administrators and other departments
Perform in - depth research into patient’s insurance, prior authorization and appeal requests on behalf of the provider

HELP DESK SUPPORT

Confidential

Responsibilities:

Participate as a member of the support team in resolving issues that arise in all departments.
Experienced in troubleshooting and technological assessment with emphasis on computer hardware and software.
Analyze and evaluate the effectiveness of IT programs or operations in meeting established goals, measures, and objectives.
Performed basic accounting tasks and data entry as needed
Experienced in various technological systems - diagnosed, troubleshoot and resolved software, hardware, and connectivity issues

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