Greater St. Louis
Experienced Account Executive with a demonstrated history of working in the hospital & health care industry. Strong sales professional skilled in Medicaid, Management, Account Management, Managed Care, and Data Analysis.
Create contracts for network pharmacies around the country for both independent and chain levels Interface with legal and account management teams to craft language and terms pursuant to product up-sells with clients Work cross-functionally with Implementations to apply contract rates and conditions into adjudication systems Coordinate approvals of final contract language through appropriate delegation of authority Organize and manage network contracts for Medicare and Department of Defense TRICARE units EXAMPLE 1: Project managed over500 executed contracts for 2009 EXAMPLE 2: Created contracts for 200 chain retailers to support a vaccine product covering 1.7 million lives for Flu shots in face of H1N1 pandemic Express Scripts, Inc./HealthBridge Reimbursement Services 2007-2008, Reimbursement Specialist Performed case management to facilitate reimbursement and access for pharmaceutical drugs to patients Completed benefits investigations of Medicare, Medicaid, and private insurance patients and research of alternate funds to determine member benefits and PAP patient eligibility Assisted with benefits investigations and case coordination to Novartis TOBI and Astra-Zenica Patient Assistance Programs
Generated HIPAA compliance forms through e-signature implementation making office paper-less Assisted patients to rooms and prepared them for outpatient physician visit Completed medical billing and insurance claims including Medicare Part B, maintained payroll, e-filing Developed financial spreadsheets and cost analyses for medical and spa businesses