patient access specialist resume example with 18+ years of experience

Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000,
Professional Summary

Outgoing Patient Access Specialist/ Field Reimbursement manager that thrives on enhancing customer relationships by providing solutions to access and reimbursement challenges. I have 15 + years experience as a practice manager , medical biller, and a field reimbursement manager . I have exceptional knowledge in the areas of access and reimbursement. I have a thorough understanding of reimbursement challenges that customers face and dedicated to providing the necessary solutions.

  • Medical billing and coding ( Including Buy and Bill)
  • Healthcare reimbursement, patient assistance, Benefit Investigation, Prior Authorization
  • Territory Management
  • Protected Health Information
  • Microsoft Office Suite, Type: 70 WPM
  • Strong verbal communication
  • Client assessment and analysis
  • Veeva
Work History
12/2018 to Current Patient Access Specialist Gundersen Health System | Decorah, WI,
  • Provide education on Company's access and reimbursement services including patient support services, and reimbursement solutions
  • Offer assistance from prescription to fill, supporting the entire access journey through payer prior authorization to appeals/denials requirements procedures and forms
  • Act as an extension of the hub/call center by leveraging Patient Healthcare Information (PHI) to support the benefits investigation & prior authorization processes
  • Work closely with key customers to identify reimbursement challenges and to direct them to appropriate resources to resolve existing issues
  • Serve as an expert point of contact for sales team members to collaboratively work to enhance customer experience
10/2016 to 12/2018 Field Reimbursement Manager Covance | Detroit, MI,
  • Provided assistance to key accounts to help overcome access barriers for key client stakeholders
  • Ensured all actions taken create a positive impact on the patient journey and the brand experience
  • Developed and executed geographical strategic and tactical plans to meet customer and business needs
  • Provided education and support to targeted accounts and HCPs on support programs and available patient access services
  • Provided feedback to internal teams on local payer trends and access issues
  • Reviewed patient insurance benefit options, validate prior authorization requirements and identify alternative funding/financial options through patient assistance programs
  • Reviewed appropriate billing and coding for products and assist with resolving reimbursement issues
  • Coordinated with our client's patient support services programs representatives of reimbursement hubs
  • Built and maintained relationships with DM's, sales partners and Payer Account tips while providing support for patient access and reimbursement
  • Provided reimbursement support services including web based provider programs
  • Maintained HIPAA compliance with all activities pertaining to phi
  • Provide information on relevant reimbursement topics related to client's products
  • Plan and manage territory routing while maintaining within budget limits
  • Submitted accurate expense reports within a timely manner
  • Presented monthly compliance updates and tutorials to current team
06/2002 to 10/2016 Practice Manager Cbiz, Inc. | Detroit, MI,
  • Directed management of specialty practice for over 300 monthly patients and 6 administrative/clinical staff members while using communication skills to improve client relations by providing pertinent information relating to policies and accounts
  • Primarily responsible for coding& reimbursement of buy and bill specialty medication for RA treatment including infusions and injections of biologics
  • Worked with Medicare, Medicaid and private insurance companies to secure prior authorizations for specialty medication
  • Maintained relationships with pharmaceutical representatives to stay abreast on changes regarding product changes and insurance reimbursement ,
  • Coordinated with sales representatives to keep provider up to date on prior authorization requirements, coverage status, processes and timeline
  • Trained and educated staff on the prior authorization and reimbursement policies or specialty medication
  • Educate patient on patient assistance programs and services related to assistance with specialty medication
  • Prepare daily and monthly and quarterly revenue reports
  • Manage and maintain database of 3000 patient demographics, visits, referrals and diagnostic testing information
  • Coordinate multiple office functions that focus on computerized scheduling, electronic billing, reimbursements, collections, accounts payable/receivable, patient records
  • Perform billing and coding for practice
  • Provided verification of eligibility, co-payments and referrals for each patient
  • Maintained schedules of office staff including approving time off requests
  • Handled all forms of correspondence such as telephone, fax and e-mail
Expected in 2000 Bachelor of Arts | Communications, Business Administration Howard University, Washington, DC, GPA:

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Resume Overview

School Attended

  • Howard University

Job Titles Held:

  • Patient Access Specialist
  • Field Reimbursement Manager
  • Practice Manager


  • Bachelor of Arts

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