Ron Legamaro Email & Phone Number

Greater Philadelphia Area

Respond to requests for service via inbound call, email and live chat. Multi-task across various apps and programs to provide support, resources and information regarding all aspects of MS while utilizing active listening skills to build rapport and relationships.Conduct a thorough assessment of the client's needs and determine their ability to set realistic goals and implement a plan of action. Identify individuals unable to act under their own initiative and advocate on their behalf. Manage at least 30 individual cases until all current issues are resolved. Leverage resources with agencies, organizations, and institutions providing services to those affected by MS such as; home modification specialists, disability attorneys, financial planners, and social service agencies. Utilize local, state and federal benefits systems to ensure stable living environments. Identify employment issues related to living with a chronic disease including reasonable accommodations and leave under the Americans with Disabilities Act. Deliver support to clients in distress in a calm and solution focused manner. Recognize a crisis situation and assess for danger or harm to self or others, as well as assessing for abuse and neglect. Negotiate intervention of police, adult protective services or other local authorities to ensure the safety and welfare of the client.Diversity, Equity and Inclusion workshop facilitator. Active member and participant of several DEI Employee Resource Groups; Voices/Allies, LGBTQIA+ Pride/Allies. Volunteer at Bike MS and Walk MS fundraising events.

Chesterfield, Mo

Provided education and support to patients/families with rare autosomal genetic diseases including cystinuria, peroxisomal disorders, bile acid synthesis disorders and cerebrotendinous xanthomatosis.Facilitated new patient enrollment by creating a profile in CPR+, conducted benefit verification, processed prescription, explained program services and set patient journey expectations. Educated new patients on the importance of drug adherence and helped them develop a plan of action. Aided patients/families in obtaining life-sustaining or life-saving medications they could not otherwise afford through various patient assistance programs and drug manufacturer.Assisted patients with Medicare Part D prescription drug plan reviews prior to open enrollment. Verified current medications, frequency and dosage in order to conduct a thorough review of available plans. Educated clients on the advantages of each Part D plan to empower them to choose the best plan to meet their needs.Assisted healthcare professionals in obtaining drug prior authorizations for Commercial, Medicare, Medicaid, Tricare insurance plans, and supported clinical appeal nurse with denials. Coordinated with payer team to resolve contract issues and obtain LOA's.Trained new coordinators and worked with all coordinators to resolve challenging patient, insurance and reimbursement issues.Collaborated on several projects writing instructions and SOP's for our care team which became standards across all care teams. Assisted with updating, verifying and documenting physician credentialling in our database for ACHC accreditation.

Greater St. Louis Area

Promoted to this position to successfully manage up to 65 individual member cases.Created a white glove customer centric experience by being the single point of contact for customers that require specialized support due to complex medical needs. Collaborated with peers, social worker, clinical case management, service implementation and healthcare professionals to resolve issues related to claims, pharmacy authorization, medical/pharmacy benefits, and eligibility. Conducted monthly review of all claims and routed any incorrectly processed to the claims department for correction.Knowledge of medical terminology and CPT, HCPCS, ICD-9, ICD-10 codes. Proficient in various applications and platforms including; Facets, Proclaim, OneView, Epro, EncoderPro, ClaimsXten, Argus, CCMS, ProviderLink, Remedy, IEX, Sharepoint, and Microsoft Office Suite.Pharmacy Customer Service Advocate 01/2014 - 06/2015Cigna – Saint Louis, MOSupervised, mentored, trained, and coached new hire training class as a subject matter expert.Answered inbound service calls in a fast-paced call center. Educated customers on their pharmacy plan benefits and helped them obtain medications by working with health care professionals to obtain proper documentation and authorizations. Researched complex issues across multiple databases and worked with support resources to resolve member issues related to pharmacy benefits, eligibility, and claims.Resolved issues while under stress by demonstrating personal resilience and conflict management skills. Owned a problem through resolution on behalf of the member in real time or through comprehensive and timely follow-up.

Greater St. Louis Area

Implemented plans to increase sales in an assigned territory of retail accounts. Effectively managed time and resources to produce a 5% increase in territory sales.Executed and maintained merchandising strategies in the greeting card, gift wrap, party supply and promotional/seasonal departments. Built and maintained relationships with store management, employees and customers. Trained peers and management on internal system supports and implementation plans.