 Assisting the AI system in completing insurance verification phone calls..  Conducted external research to identify appropriate alternate funding sources for inclusion in a timely manner. Ensured the quality record and researched healthcare treatments, insurance providers, and reimbursements models.

• Work with healthcare providers and patients to assist with appeal management for claim denials.• Work with physicians and payers to advocate for product specific coverage. Ability to communicate product benefits and efficacy to positively influence payer policy.• Capability to monitor drug coverage policies for multiple payers. Review case outcomes to analyze and identify payment and denial trends as well as key findings for client reporting.• Conduct external research to identify appropriate alternate funding sources for inclusion in the internal resource database for future reference purposes.• Ability to effectively respond to escalated issues and complex cases referred from other Reimbursement employees or manufacturer representatives.• May be aligned and interact with territory FRMs or sales reps to assist in overcoming coverage barriers.

· Greeting and treating all patients and customers in a courteous manner. Ensures all patient registration is completed. · . Registers client information in business software according to standard operating procedures.. Maintains all PSC/ Phlebotomy logs . Responsible for data entry into PSC systems, Obtain accurate billing information. Maintains required records and documentation. . Follows HIPAA Compliance regulations

· Works in an inbound, high-volume call center environment providing remarkable service to customers.· Answers patient inquiries in a timely manner, gathering all required information, making referrals, and responding with care.· Maintains strict confidentiality guidelines and HIPAA laws to effectively support clients’ privacy.· Manages multiple calendars in real-time and books appointments preventing conflicts in scheduling.· Ensures easily accessible client records maintaining up-to-date treatment information and correct filing of patient records.· Serves as a liaison between clients and service providers, ensuring to communicate pertinent work status information and steady flow of clients in office.· Displays extensive knowledge of all procedures, including record management and document processing.· Registers client information in business software according to standard operating procedures.

· Performed essential accounting functions such as balancing drawers, balancing deposits and withdrawals, and auditing financial paperwork.· Greeted customers warmly upon arrival and exceeded expectations by performing payment transactions with ease ensuring all concerns were met promptly.· Received payment information via phone and in person, inputting transactions in POS systems quickly and accurately.· Enforced federal reporting guidelines and internal transactional limit guidelines to process and execute financial transactions.· Handled in-person payments, prepared invoices, and monitored payment status. Applied all transactions to ledger upon receipt.· Achieved financial transactions in accordance with state, local, and federal guidelines.· Verified customer’s identity to cash checks, money orders, and other legal tender.· Processed requests for money orders, wire transfers, and money cards.· Enforced policies concerning promotions, coupons, and payment options.· Researched and resolves customer complaints.

· Responsible for providing high-quality customer service, patient counseling, and interventions via Help Line calls.· Coordinated the distribution of healthcare-related services, educational material, and literature to support client programs.· Built relationships with community agencies to provide legal and social services to shareholders.· Answered incoming calls to assess client needs, restate issues, and determine next course of action.· Performed data entry entering highly sensitive information into electronic protocol tracking and correspondences system.

· Served as a liaison between the business medical providers and customers.· Maintained electronic records and secured confidential patient data according to HIPAA guidelines and policies.· Communicated with customers via phone, and email to document and record prescription orders, and answer basic process questions.· Educated customers on pharmacy resources and supplies. Provided excellent customer service at every interaction while promoting health and wellness.· Submitted and created prior authorization cases for member’s medication under the terms of their plan, for the CVS project.· Responded to incoming faxes and calls from doctor’s office and members. · Coordinated fulfillment of medical record requests, prescription refills, prior authorizations & referrals.