Kellie H. Email & Phone Number

• Demonstrate in-depth knowledge of Medicare and Medicaid to inform patients of their eligibility, benefits, and enrollment windows
• Create detailed insurance plan breakdowns for patients to help them understand their co-pays, co-insurances, and prescription drug formulary
• Answers incoming calls, emails, and other forms for communication with Compass.
• Demonstrates clear and effective communication skills in all forms of communication.
• Collects pertinent information to identify and assess the needs of the customers.
• Applies knowledge of healthcare programs to help customers assess insurance options and navigate complex coverage and reimbursement issues.

Cedar Knolls, NJ

• Coordinated care for patients with a contracted DME or pharmacy to receive oral formula prescriptions through provider referrals by overcoming reimbursement challenges, navigating the payer system, verifying insurance.
• Comprehended landscape of access to metabolic portfolio through education and sales meetings.
• Expanded coverage of products in key geographic regions or with key authorities by working with territory manager and sales.
• Accommodated medical professionals with health plan prior authorizations, pre-determinations, coding, and appeal issues by developing a plan of action.
• Utilized Policy Reporter to research and monitor insurance company policies and summary plan descriptions to find any and all avenues of opportunities for coverage.
• Proposed and assisted patients in application process for an internal assistance program to provide financial aid for patients with denied insurance coverage.

Florham Park, NJ

• Submitted medical necessity and corrected claims for each service to reprocess unpaid claims.
• Lead patient benefits analyst to ensure coverage of care and to aid in developing a treatment plan.
• Documented monthly stats in excel for special procedures to help accurately depict patient count.
• Decreased delinquent cases by sending out weekly bills to patient's with an outstanding balance.
• Coordinated with external parties, such as lawyers, to assemble patient records for settling cases.
• Answered phones and made appointments with customer service skills to increase patient satisfaction.

Bachelor Of Arts (B.A.), Communication And Media Studies

Associate Of Arts (A.A.), Communication And Media Studies