Paul Moor
Peoria
Summary
Detail-oriented Insurance Specialist with a strong background in insurance verification and prior authorization. Adept at facilitating patient access and resolving coverage issues, ensuring high-quality service and compliance with industry standards.
Overview
8
8
years of professional experience
Work History
Insurance Specialist /Customer Service Representative
McKesson Specialty Health
Scottsdale
12.2019 - Current
Verified insurance requirements, including prior authorizations and non-formulary exceptions, to facilitate patient access to medications.
- Coordinated with healthcare providers and insurance carriers to resolve coverage issues, enhancing patient access to necessary treatments.
- Delivered high-quality customer service while managing sensitive information in compliance with HIPAA regulations.
- Assisted patients with program eligibility and application status updates, improving overall patient satisfaction and support.
- Tracked medication shipments, ensuring timely delivery of therapy and maintaining continuity of patient care.
- Processed medication refill requests while maintaining accurate records for continuity of care.
Insurance Specialist
McKesson Specialty Health
Scottsdale
07.2018 - Current
Communicated with insurance carriers regarding prior authorizations, non-formulary exceptions, and appeals for medication coverage.
- Supported patients and provider offices by addressing inquiries regarding coverage and reimbursement, ensuring timely resolutions.
- Facilitated patient access to Aimovig therapy through collaboration with healthcare providers and clear communication of payer requirements.
- Processed new patient enrollment applications, ensuring accuracy and timeliness of program enrollment.
- Documented patient cases and insurance determinations comprehensively, ensuring compliance with program standards.
Education
Pharmacy Technician - Pharmacy
Kaplan College
Palm Springs, CA07-2006
Skills
- Insurance verification
- Claims processing
- Medical coding
- Prior authorization
- Prior authorization
- Patient advocacy
- Client relationship management
- Patient enrollment
- Insurance verification
Timeline
Insurance Specialist /Customer Service Representative
McKesson Specialty Health
12.2019 - Current
Insurance Specialist
McKesson Specialty Health
07.2018 - Current
Pharmacy Technician - Pharmacy
Kaplan College