Nathaniel R Email & Phone Number

Advocated for patients by investigating healthcare benefits, while completing prior authorizations in an efficient manner.Engaged in all facets of prior authorization from obtaining patient information to completion, and ensured that patient coverage was properly attained.Collaborated with my reimbursement team to streamline and unify directive orders for clients, thereby optimize ing our services and client experience.Active liaison between patients and healthcare providers by addressing the high volume of billing related phone calls and email queries.Proficient in Tableau, Excel and Google Suite with knowledge SQL and queries. Knowledge on Github and R language.

-Performed benefit investigations and prior authorizations follow ups on patient's health insurances.-Met and exceeded daily benefit investigations of 18 patients a day. Performed at the top 10% daily for benefits completed.-Averaged a 90% compliance score for calls. -Able to research and manage highly complicated benefits to provide case managers clear and concise patient benefit information. -Deep knowledge of disease states, specialty medication, and insurance coverage.-Detecting medical policy and what is covered medication and what disease states are not covered in a patient's policy.-Breaking down complex insurance situations to help patients acquire their medications and keep them on treatment.-Communicate to Case Manager problematic reimbursement issues to provide better services for the patients that are taking the medications.-Heavy data entry and telephone contact resulting in high performance for the team metrics.Verify commercial and government payers policies for Benefit Investigation Reports for the providers.-Working with Case Managers to help understand each patient's benefit structure so that the patient will know their responsibility for the medication on time and accurately.-Speciality Medication knowledge: Oncology medications, Allergic medication, Multiple-Sclerosis medication, and Rheumatoid artritis medication.

-During the peak season of new enrollments I met my Service Activity quota and exceeded the daily goal of 70+ activities. -Received a 90% and above for compliance and customer satisfaction for all my calls. -Blizzard Contractor 2018. Two months of working 8+ hours everyday.-CRM Trained and comfortable with Salesforce customer data collection.-Effectively managed physician offices resulting in customer satisfaction and trust in Genentech products and services.-Maintaining and building on relationships with the providers that subscribe the treatment. Trying to be the bridge to help patients stay on the medications.-Evaluation of claims, denials and payer policies for compliance and identify barriers in reimbursement for our external partners.-Responsible for review of benefit investigations reports completed by Reimbursement Specialists for relaying patient responsibility to the patients and the provider.-Identifying payer trends and understanding certain patterns that can help me be a more effective case manager.

-Brand development, web site traffic growth, web site UI and advertising revenue. Developed brand strategy and statistics systems.- Worked as an Assistant Production, researched and analyzed. -Camera work

Established new territory for the company. Generated at least a 15% increase in patients. Visit establishments to evaluate their needs or to promote our services. Networking and relationship building with hospital staff, such as case managers and social workers, to give sight and visibility to the company’s home health services.Hosting promotional and informational events to hospitals, doctors, and assisted living facilities.

San Francisco Bay Area

Headed new territory which generated 12% more patients which lead to a 7% revenue growth. Visit establishments to evaluate their needs or to promote our services. Networking and relationship building with hospital staff, such as case managers and social workers, to give sight and visibility to the company’s home health services.Hosting promotional and informational events to hospitals, doctors, and assisted living facilities.