Compassionate and organized Case Management Specialist, with proven success supporting patients and healthcare professionals.
that contributes to the
attainment of team and
Proven ability to
follow up and anticipate
displaying integrity and
professionals at all
Healthcare billing proficiency
Third Party Liaison
Problem resolution ability
Reduced commercial insurance AR at Compass Medical from 38 days to 32 days in December 2015.
Employee of the Month, L. Brands Inc. September 2015.
06/2016 to Current
Patient Services ManagerShire － Lexington, MA
Completed eight week HAE Sales Start training program during Shire Orientation
Support over 200 HAE patients across Utah, New Mexico, Arizona, and New York access one and/or all of Shire's HEA medications Firazyr, Cinryze, and/or Kalbitor
Assist and aid office medical staff obtain prior approval, co-pay assistance, and
injection training for HAE patients so to access the HAE medication they are prescribed.
Drive patient accruals and adherence by entering and maintaining
accurate records in OnePath database SalesForce
Explain and educate HAE patients and medical professionals on OnePath services
Troubleshooting and resolve reimbursement issues for patients accessing an HAE therapy
Work closely with pharmacy HUB (LASH) to ensure the process of patient referrals/Start Forms
are managed timely and appropriately triaged to a specialty pharmacy
Attend and participate at patient meetings, conferences, and Shire Sales Meetings as required
Follow all HIPAA regulations to ensure patient information is held to the
highest confidentiality standards
Management of area Key Physicians and office staff, offering direct support assisting
patients gain access to one of Shire's HAE therapies
01/2013 to 06/2016
Medicare Billing SpecialistSMG Compass Medical － East Bridgewater, MA
Billing for patient services in primary care and a variety of other specialties
Ensuring claims are coded properly for prompt payment
Correct denials with Medicare by phone and through their online reopening feature
Posting electronic remittance advice received from Medicare
Work directly with patients and Medicare to resolve coordination of benefit issues
Resolving inquires for patients, insurance companies and other entities involved
Provide excellent customer service when taking inbound calls through a call center
Ensuring HIPAA guidelines and compliance procedures are followed
Experience with commercial insurances and third party liability claims
Trained to reconcile daily bank deposits from multiple entities
Knowledge of Current Procedural Terminology and ICD-9/ICD-10 Medical Coding.
01/2012 to 01/2013
Mental Health AssociateUnited Health Services － Pembroke, MA
Assist patients with cognitive and behavioral disorders with activities of daily living
Recording information for up to 27 patients at a time for professional evaluation
Act as a liaison between patients and nurses, doctors and case workers
Leading interactive therapy groups and brain exercises
Verifying insurance eligibility and prescription coverage
Safeguard in-patient hospital environment for patient and staff safety.
10/2009 to 07/2016
Commercial Billing Specialist, Clerical Office AssistantL. Brands Inc. － Kingston, MA
Specialty Selling Representative
Customer servicing clients with apparel and body care product questions
Extensive training and knowledge in loss prevention
Maintaining organizational brand standards; shipment processing
Frequently attended "Employees Interested In Management" brand seminars.
Other positions held: Customer Experience Supervisor, Merchandise Flow Associate.
Education and Training
Master of Business Administration: Health Care Administration and InformaticsSouthern New Hampshire UniversityHealth Care Administration and Informatics
Bachelor of Arts: Criminal Justice Psychology and SociologyCurry CollegeCriminal Justice Psychology and Sociology
Activities and Honors
Member of The National Society of Leadership & Success with Southern New Hampshire University
*Participated in a Microsoft Office teaching seminar in January 2016
Billing and coding; ICD-9/10 and CPT-4; Microsoft office and PowerPoint; Service Cloud/Sales Force; Presentation Skills; Effective Communication