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Field Reimbursement and Access Specialist Resume Example

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FIELD REIMBURSEMENT AND ACCESS SPECIALIST
Professional Summary
Highly motivated client and patient focused professional with more than ten years' experience working with numerous pharmaceutical companies and insurance providers. Specialized in working with commercial and government insurance reimbursement, providing guidance in and assists with the understanding of complex coverage challenges, and ensuring patient access to pharmaceuticals in oncology, dermatology, respiratory, infectious disease, and internal medicine. Experience working with provider offices such as a physician practice, patient assistance programs, or similar pharmaceutical support programs. Built relationships with customers and the community to promote long term business growth. Ability to integrate innovative ideas to accomplish corporate and individual objectives. With a proven record of achievement and success.
Skills
  • Patient-focused reimbursement support Excellent customer service and a positive attitude
  • Familiar with commercial and managed care insurance towards patients
  • Carriers Motivated self-starter
  • ICD-9/ICD-10 (International Classification of Disease Strong leadership and teamwork
  • Systems) Strong work ethic
  • Strong presentation skills Ability to develop priorities and manage time
  • Appropriately.
  • Billing
  • Closing
  • Oral
  • CPT
  • Clients
  • Excellent customer service
  • Delivery
  • Financial
  • Government
  • Grants
  • ICD-9
  • Insurance
  • Inventory
  • Leadership
  • Meetings
  • Mentoring
  • Access
  • Money
  • Policies
  • Presentation skills
  • Pricing
  • Profit
  • Coding
  • Protocols
  • Speaking
  • Purchasing
  • Receiving
  • Sales
  • Sales and training
  • Self-starter
  • Strategic
  • Tax
  • Teamwork
Work History
Field Reimbursement and Access Specialist , 03/2018 to Current
Company Name – City, State
Life, Health, and sickness agent ; HIFA college consultant, 12/2015 to Current
Company Name – City, State
  • Built relationships with customers and the community to promote long term business growth Interviewed clients to determine current income, expenses, insurance coverage, tax status, financial objectives, risk tolerance and other information needed to develop a financial plan.
  • Consulted with businesses to supply accurate product and service information.
  • Created strategic brand building events to expand the current product portfolio.
  • Selected the correct products based on customer needs, product specifications and applicable regulations.
  • Calculated quotes and educated potential clients on insurance options.
  • Contributed ideas and offered constructive feedback at weekly sales and training meetings.
  • Answered clients questions about the purposes and details of financial plans and strategies.
Benefits and Financial Counselor, 07/2014 to Current
Company Name – City, State
  • Conducted benefit investigation with various insurance carries.
  • Completed insurance benefit consultations with patients.
  • Seek financial assistance through various pharmaceutical copay cards and free drug programs for both medical IV drugs and oral pharmacy drugs.
  • Conducted treatment estimates via Revrunner.
  • Maintained a relationship with Walgreens specialty for oral oncology medication to ensure that each patient receives their medication.
  • Work with various specialty pharmacies nationwide.
  • Continuously meeting new medical and pharmaceutical professionals to gain more knowledge in order to help with drug reimbursement.
  • Identified and resolved patient billing and payment issues.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third-party requirements regarding billing.
  • Interacted with providers and other medical professionals regarding billing, reimbursement, procedures, and policies.
  • Opening and closing procedures for deposits and payments.
  • Provide mentoring and product training on various pharmaceutical assistance programs and reimbursement for medical IV and oral drugs in hematology and oncology.
  • Process financial assistance applications to determine patient eligibility.
  • Knowledge of Centricity and G4 billing.
  • Adjust billing claims.
Senior certified pharmacy technician, third party specialist, 05/2008 to 07/2014
Company Name – City, State
  • Worked alongside pharmacist, and district supervisors to create new procures and work flow for the new specialty location.
  • Facilitate required prior authorization process for prescription drugs; financial appeals for drug manufacture programs; and obtained financial assistance through various pharmaceutical companies and foundations for grants.
  • Sales to date 6 million.
  • Reimbursement support specialist, ensuring patient access to pharmaceutical in oncology, dermatology, infectious disease, and internal medicine.
  • Established relationship and advocated for oncology practices in Georgia, South Carolina, and North Carolina.
  • Established new bedside delivery service procedures at Gwinnett Medical Center alongside the pharmacy manager.
  • Educated numerous departments in the hospital on the bedside delivery service.
  • Offered bedside delivery sales services to the patients on seven hospital floors.
  • Assisted other pharmacy staff with drug inventory, purchasing, and receiving.
  • Assisted the pharmacists with checking in and pricing drug orders, third party transactions and relevant paperwork.
  • Worked closely with Pharmacy Care Representatives (PCRs) in providing excellent patient care.
  • Directly supervised and trained the other Pharmacy Technicians, and interns while on duty.
  • Saved patients money and increased pharmacy profit margins with therapeutically equivalent and more cost-effective generic drugs.
  • Translated pharmacy communications for Bosnian speaking customers.
Education
Bachelor of Science: PsychologyGeorgia Gwinnett College, University Center - City, State
Affiliations
Licensed life, health, and sickness GA License Certified HIFA college consultant Association of Community Cancer Centers (ACCC) Financial Advocacy Boot Camp Certification
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Resume Overview

School Attended

  • Georgia Gwinnett College, University Center

Job Titles Held:

  • Field Reimbursement and Access Specialist
  • Life, Health, and sickness agent ; HIFA college consultant
  • Benefits and Financial Counselor
  • Senior certified pharmacy technician, third party specialist

Degrees

  • Bachelor of Science : Psychology

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