Talented Decanter Ambassador and team leader offering 12 years of success in customer service environments. Strategic thinker with time management proficiency. Committed to identifying and leveraging opportunities for growth throughout the Company.
Patient Case Coordinator
Answers basic clinical and program inquiries; 24 inbound calls and 12 outbound calls daily (on average)
Coordinates access to therapies, schedules and conducts appropriate follow-up, and facilitates access to appropriate support services.
● Facilitates access to appropriate support services, including reimbursement counseling, nursing hotline, and support.
● Processes incoming enrollment forms for program.
● Follows up via phone, mail, and/or fax for missing enrollment information.
● Supports payer research, health care policy library, and state management.
● Identifies other sources of health care coverage for patients through simple queries and use of PayerPlus database
● Works on problems of limited scope. Follows standard operating procedures in analyzing data from which answers can be readily obtained. Builds stable working relationships internally.
Typically receives general instructions on routine work, detailed instructions on new projects or assignments.
● Performs related duties as assigned.
● Work with claims and explanation of benefits submitted to program for patients that are receiving copay assist from our program to determine if we will be able to reimburse doctors offices.
● Assist patients with foundation copay assist billing and claims
● Verify patient's benefits to determine whether they are eligible for program copay card or foundation copay assist upon doctor's request.
● Complete submitted application processing for patients completing UB-92, insurance verification, claims processing and excel on a case by case basis.
● Make phone calls to payer to get the prior authorization status for patients before they start receiving injection to insure they will be covered by insurance company.
● Train new employees on how to do our daily job routine.
● Process research Prior Authorizations on behalf of the physicians office via phone and web.
● Complete full medical benefit verification for Botox as of 8/1/2017 when needed.
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