Productive and good place to work.
Medical Billing and Reimbursement Specialist (Current Employee) – Lake Mary, FL – June 6, 2017
• Managed member and client expectations related to claim reimbursements. Verified member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed.
• Submitted Prior Authorizations for specialty drugs and followed up on approvals. When Prior Authorizations are denied, assisted with appeals submissions and follow up on appeals outcome with insurance companies and physician offices.
• Tracked and triaged coverage determination requests submitted from providers. Entered and documented coverage determination request into the PBM system, notified providers and/or members.