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Click here or scroll down to respond to this candidatePROFESSIONAL EXPERIENCEPATIENT ASSISTANCE SUPPORT AGENT, AMGEN (THROUGH ASTON CARTER STAFFING)TAMPA, FL AUGUST Street Address - DECEMBER 2023 Verify HIPPA information and pre-screen to determine if patients qualify to enroll in the Amgen Safety Net Foundation (ASNF). Review documentation on a case-by-case basis to submit to ASNF for final status determination. Discuss guidelines and protocols regarding denials and appeals with healthcare professionals Review off and on-label ICD-Street Address codes to report any possible adverse event, product complaint, or other safety findings. Experience using Amgen PULSE to initiate the intake process for patients, review and assess eligibility documentation and organize applications Refer healthcare professionals and patients to HCP or other medical staff to discuss plan of care and other questions about medical decisions. Provide healthcare professionals and patients with contact information for third-party charity patient assistance programs.INSURANCE VERIFICATION SPECIALIST, THE ONCOLOGY INSTITUTE OF HOPE AND INNOVATION TAMPA, FL JUNE 2021 - MAY 2022 Verify insurance, patient eligibility, and coverage. Respond to email inquiries regarding status. Calculate a patients copay according to health plan coverage for chemo drugs and administration. PAYER ENROLLMENT COORDINATOR, CVS HEALTHWOONSOCKET, RI OCTOBER 2019 - MARCH 2020 Process Railroad Medicare applications for providers. CAQH experience processing over 3,000 providers in 34 states for MC. Assisting with email communications for MC providers. Proficient in MD staff software. INTAKE/ENROLLMENT COORDINATOR, CARECENTRIXTAMPA, FL JANUARY 2013 - NOVEMBER 2018 Contact health plans or payers to gather policy benefits/limitations and complete eligibility and benefits verification to ensure the carrier will cover the services provided. Pull forms from different health plans in order to submit clinical docs for review & obtain authorization from the health plan. Resolve discrepancies in a professional and timely matter. Check patient eligibility and enter it into the system & portal. Contact in and out-of-network providers to set up new referrals in order to assign Home Health Services; negotiate rates, and set up Letters of Agreement. Participate in voluntary work when Cigna claims need support. Marta VelezPHONE NUMBER AVAILABLE EMAIL AVAILABLECLAIMS ADMINISTRATOR / CHECK LOGGER & CORRESPONDENCE, AETNA TAMPA, FL JUNE 2010 - OCTOBER 2012 Use different types of software in order to verify information; ACAS, OPT, ASD, GENELCO. Log checks in a timely manner following regulations and procedures. Process letters to members & providers requesting overpayment; call providers in order to request more documentation if needed. All office duties i.e., filing, faxing, scanning documents, etc. BANKRUPTCY / PROCESSOR / INTAKE SPECIALIST, SHAPIRO AND FISHMAN LAW FIRM TAMPA, FL - JANUARY 2005 TO MAY 2009 Set up referrals, and enter data into a computer using various data entry devices Prepared source data for computer entry by compiling and sorting information Reviewed source & pacer & resolve discrepancies. Maintained data entry requirements by following techniques and procedures and more Reading Pacer Ch. 13 and Ch. 7 Docket Informed, and escalated clients of the status of their case by LPS, Vendorscape, Ocwen, Regions, Citi Review files from foreclosure and logged out closing files; updated information into the system and notified the client. Drafted, reviewed, and sent out bankruptcy correspondence to clients All office duties i.e., filing, faxing, scanning documents, etc. EDUCATIONConcorde Career Institute; Tampa, FL - Diploma, Insurance Billing & Coding Specialist, 2010 SKILLS Fluent in Spanish and English Proficient in Microsoft Office Suite Skilled in insurance verification and data entry in a medical setting |
