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Reimbursement Care Coordinator
Reimbursement Care Coordinator at Payer Matrix, coordinating specialty medication access through assistance programs and payer coverage.
United StatesReimbursement Care Coordinator at Payer Matrix
Served as primary contact for self-funded plan members prescribed high-cost specialty medications, coordinating access through manufacturer PAPs, foundations, and financial assistance programs. Resolved coverage and access issues by contacting PBMs, funds, and plan sponsors.
Patient Assistance ProgramsPayer Policy Research340BCRMCase ManagementAppeals ProcessingBenefits InvestigationUtilization Management
Explained prior authorization status and requirements to providers and members, and helped pharmacies resolve denials by providing plan-specific information. Served as first-line contact for PBM benefit questions and maintained accuracy against contact-center metrics.
Prior AuthorizationsPBMsClaims ProcessingCustomer Service340BData AnalysisMicrosoft OfficeSQLGoogle Sheets
Pharmaceutical CompoundingUSP 800Inventory ManagementQuality AssuranceDocumentationPharmacy Operations
Received inventory, completed cycle counts, and maintained pharmacy organization to board and CVS standards. Counted, labeled, and prepared finished prescriptions after pharmacist approval, and resolved third-party rejections to ensure patients received medications.
Pharmacy OperationsInventory ManagementInsurance BillingCustomer ServiceHIPAAControlled Substances
Associate of Arts in Health Service Administration from Keiser University, West Palm Beach, FL.
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