Reimbursement Case Manager Resume Example
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REIMBURSEMENT CASE MANAGER
Skill Highlights
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Professional Experience
Reimbursement Case Manager, 03/2016Francisan Health － Munster , IN
- Generate and maintain working relationships with offices and pharmaceutical area managers in 16 states Perform outbound calls to payers to obtain accurate product-specific coverage Conduct research to identify appropriate alternate funding sources Follow each case from start to finish to ensure timely delivery of medication to the patient or office Effectively respond to escalated issues or complex cases.
Reimbursement Specialist, 10/2013 to 03/2016Newton Medical Center － Valley Center , KS
- Top performer on a production-driven team, consistently exceeding daily and monthly quotas while maintaining an error rate below 1% Perform outbound calls to payers to obtain medical and pharmacy coverage for two specialty medications Accurately input benefit details in Salesforce Design benefit investigation tools and update training materials.
Surgery Scheduler & Biller, 08/2010 to 09/2013Partners Healthcare System － Concord , MA
- Manage surgery schedules for 6 physicians, coordinating all inpatient, outpatient, and in-office procedures at multiple.
- facilities.
- Verify medical benefits and initiate required authorizations.
- Confirm accurate ICD-9 and CPT codes for office services, surgeries, and deliveries, and post charges.
Receptionist, 08/2008 to 07/2010Canyon State Urology － City , STATE
- Greet all incoming patients and provide excellent customer service.
- Schedule follow-up appointments and office procedures.
- Assist with referrals, scanning, and answer phones as needed.
Customer Service Specialist, 03/2007 to 08/2008NextCare Urgent Care － City , STATE
- Efficiently manage high volume check-in, monitor the flow of patients, and receptively answer customer questions.
- Ensure accuracy of demographic and insurance information.
- Process patients for discharge and assist with other front office duties as needed.
Education and Training
Bachelor of Science:Business and Marketing,2014University of Phoenix － City, StateBusiness and Marketing
Skills
attention to detail, benefits, CPT, excellent customer service, delivery, focus, front office, ICD-9, insurance, Excel, office, Outlook, PowerPoint, Microsoft Word, works, multitasking, research, scanning, Self-motivated, surgery, answer phones, training materials, written communication skills
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Resume Overview
School Attended
- University of Phoenix
Job Titles Held:
- Reimbursement Case Manager
- Reimbursement Specialist
- Surgery Scheduler & Biller
- Receptionist
- Customer Service Specialist
Degrees
- Bachelor of Science : Business and Marketing , 2014
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