Colette Bailey Email & Phone Number

• Provided timely response to patients’ inquiries by telephone, email, or outbound service center, consistent with service and quality standards• Provided pricing, availability, and scheduled information within established guidelines • Received inbound and outbound calls to patients or MD offices regarding orders for medications, pharmacy services and all other inquiries • Coordinated patient care by scheduling orders, communicating information to the patient regarding shipments, assessing supply needs, verifying patient information, notifying the pharmacist of issues or changes in the patients’ condition and to alert the pharmacist of any medical compliance issues.• Provided correct information or direct calls to the appropriate team member or department with maintaining a high level of professionalism • Maintained and Ensured excellent patient relations and that claims and complaints were resolved fairly and effectively• Documented all communications received from phone calls and provided notification of any urgent orders, shipping related issues and any errors, complaints or compliments to the appropriate party or system• Recorded and processed orders and/or inquiries received by fax, mail, telephone and through patient direct contact

Dallas/Fort Worth Area

• Supported the administration of hospital care, case management, and quality management processes in compliance with various laws and regulations • Outreached and screened patients using targeted intervention processes to identify needed medical services• Identified triggers for referral into Aetna’s Case Management, Disease Management, Mixed Services, and other Specialty Programs• Developed service plans for nonclinical service needs • Implemented referrals, scheduled appointments, arranged transportation and reminder follow-up calls • Interpreted and applied various guidelines across multiple insurance plans • Forwarded member case files to Clinical staff, Behavioral Health or Medical case managers to ensure all case management needs were met

Dallas/Fort Worth Area

• Authorized pre-certification for hospital stays• Verified insurance coverage through member services and internal system • Contacted hospital utilization review department for information regarding hospital stay• Established credibility with external providers • Effective and credible discussions with clinicians/case managers • Used Clinical judgment to make appropriate accommodations; escalated issues as appropriate • Identified intervention/needs necessary to improve patient outcome