Arlene Sawyer
Gurnee
Summary
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
18
18
years of professional experience
Work History
Case management
AbbVie/Pharmacy Solution
09.2016 - 01.2025
- Partner with HCPs independent, effective professional communication, troubleshooting and prompt issue resolution
- Effectively communicate to HCPs and Patients regarding insurance coverage, case status, and Pharmacy Solution Services
- Assist the pharmacist with the practice of pharmacy in accordance with federal, state, and local regulations, HIPAA guidelines and corporate and departmental policies and procedures by accurately interpreting healthcare provider’s prescription orders and entering this information into the core pharmacy system
- This includes all physician demographic information, and referral and/or prescription information
- Conducts quality case reviews to ensure the highest quality of work is being done
- Identifies and recommends process/system improvements that increase efficiency and productivity and communicates ideas with supervisor
- Understand and comply with all required training, including adherence to federal, state, and local pharmacy laws, HIPAA policies and guidelines, and the policies and procedures of Pharmacy Solutions and AbbVie
- Maintain current licensure and CE requirements as necessary
Pharmacy Solutions Partner
AbbVie/ Pharmacy Solution
04.2013 - 09.2016
- Investigate rep escalation process promptly with customer cases
- Performs additional tasks, actives, and projects as assigned by management
- Provides follow up with HCP to advise delays in referral processing or prescription forwards
- Ensures proper information and data is being checked prior to releasing to HCP
- Supports PSP activities set by other functional areas
- Creates long term relationships with Hcp through communication
- Explains the value of applying for copay cards
Benefits Associate
Aon Hewitt
09.2012 - 11.2012
- Answered calls from team regarding health savings, payroll, and retirement plans
- Evaluate customer needs
- Process Medicare and commercial medical insurance plan choices including benefit calculations
- Set up new and existing patient enrollment
Customer Service Representative
Fresenius Medical Care
01.2012 - 04.2012
- Worked with patients on dialyses to facilitate treatment and orders for medical supplies
- Daily management multi-lined phone system for West Coast region
- Process patient orders for their dialyze solutions
- Handles various patient and clinic orders
- Communication with patients, advocates, clinical staff, and other businesses
Clerical Associate/ Enrollment
CVS Caremark
02.2010 - 01.2011
- Collect and input new patient demographic, insurance, and medical history
- Received referrals via phone/email and input into computer system along with therapy options
- Outbound calls to gather additional information for patients
- Assisted supervisor with special projects
- Answered multi-line telephone, routed calls, and took accurate messages
Sales Associate
LTD Commodities
08.2006 - 03.2009
- Order processing / data entry
- Receive inbound and places outbound calls
- Performed faxing, photocopying, and filing duties
- Trained new hires
- Handle confidential credit files
Education
Pharmacy Tech - ExCPT
National Healthcare Association
04.2015
High School -
North Chicago High School
North Chicago, IL06-2003
No Degree - Human Resources Management
Herzing University
Wisconsin Rapids, WI08-2028
Skills
- Medicare and Medicaid
- HIPPA Guidelines
- Salesforce
- Reimbursement & Claims:
- Prior Authorizations
- Appeals/Formulary Exceptions
- Market Access and Payer Relations
- PBM and Payer Policy
- Insurance Verification
Timeline
Case management
AbbVie/Pharmacy Solution
09.2016 - 01.2025
Pharmacy Solutions Partner
AbbVie/ Pharmacy Solution
04.2013 - 09.2016
Benefits Associate
Aon Hewitt
09.2012 - 11.2012
Customer Service Representative
Fresenius Medical Care
01.2012 - 04.2012
Clerical Associate/ Enrollment
CVS Caremark
02.2010 - 01.2011
Sales Associate
LTD Commodities
08.2006 - 03.2009
Pharmacy Tech - ExCPT
National Healthcare Association
High School -
North Chicago High School
No Degree - Human Resources Management
Herzing University
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