Jabrille Landfair
Wheaton
Summary
Customer service oriented professional who provides timely and accurate data to ensure reimbursement for patient services. Follows policies, procedures and guidelines to assure consistent quality. Maintains and ensures patient privacy and confidentiality.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Senior Appeals Pharmacy Technician
Optum RX
09.2023 - Current
- Discuss medications, insurance and prior authorization documents with patients
- Answer prior authorization inquiry calls or/and faxes as well as research and resolve formulary and benefit issues using the appropriate reference material
- Resolve issues and complaints in a timely manner
- Performs other duties as assigned by management
- Get Prior Authorizations approval from insurance firms and nurse managers
- Appeal insurance companies after Prior Authorization refusal
- Advanced with working with Medicaid, Medicare Part B/D, HMO and PPO
- Access Accounts for completeness and accuracy
Patient Care Coordinator / Pharmacy Infusion Technician
Vitas Healthcare
Lombard
08.2021 - 09.2023
- Promptly answers and screens incoming calls with the appropriate escalations as needed
- Ensures timely and accurate VX documentation on all tasks completed in accordance with telecare documentation standards to ensure data Integrity
- Takes ownership and resolve all customer service issues with first call resolution whenever possible
- Communicate Via skype and via outlook for updated patient's information
- Maneuvering thru patient's chart to make sure the chart is accurate
- Making patient's charts active or discharging as needed
- Transferring calls to triage nurses via southeast and west coast based on the patients needs
- Great customer service skills
- Pharmacy Tech Duties
- Communicating with Pharmacists from One point and Pharmerica to make sure they received the order via fax
- Making sure the meds are in stock, Placing orders in E3, such as the written quantity and concentration for certain medications
- Communicating with pharmacy operations to make sure the orders and the custom infusions selections are correct
- Checking the pt's demographics to make sure that the order will be delivered in a timely manner
- Infusing Iv meds and asking questions based on what the pt's needs are
- Communicate with field operations staff to clarify and or identify necessary items for documentation
Reference Coordinator (Send Out Lab)
Loyola University Medical Center
Maywood
08.2020 - 08.2021
- Sending out Different Specimens to different labs, Such As Mayo Clinic, Labcorp, Quest, John Hopkins etc
- Matching Orders In EPIC, to make sure Tests are Correctly Order
- Calling and sending In Basket Messages To Doctors and Nurses regarding Critical Labs and Test Results
- Canceling test based on Doctors Request
- Shipping out specimens on dry ice to infer timely delivery
- Checking EPIC to make sure Patient Information matches records
- Scheduling patients, for appointments to get blood work redrawn thru EPIC, reading test results, abiding by the HIPAA Law
Core Processor (Support Service Tech)
Loyola University Medical Center
Maywood
09.2018 - 08.2020
- Supports the delivery of patient care through the receipt, processing, and routing of specimens
- Provides customer friendly service to any person requesting supplies or information by phone, computer or in person
- Ordering Test Through Epic, typing 45-50 WPM
- Receiving Add on test, through Epic, Efficient in Sunquest and EPIC
- Receiving Specimens Manually if their shorts, Criticals, ER, STATS, Cath labs, stroke samples, send outs or special testing for Specials or DXC samples
- Great Customer service skills, answering phone calls and giving out test results to Nurses, or Doctors, through Sunquest
- Triaging, separating samples from Blood Bank Microbiology, and any other test that needs to go to other departments
Overnight Specimen Processor (Data Entry Specialist)
Antech Diagnostics
Oakbrook
01.2017 - 09.2018
- Receives and prepares samples for laboratory analyses and tests to diagnose various pet and other animal illnesses, injuries and diseases in support of veterinarian animal treatment
- Removes specimens from transport bags and splits as needed for multiple testing
- Places specimens on slides or other testing formats
- Retrieves and prepares add-ons and rechecks
- Entering over 500-800 processing forms for doctors to overlook regarding information
- Abiding by the HIPAA act according to animals testing privacy
- Processing Multi-Request forms, and regular forms based on Priority needs
- Scanning documents to make sure information Is accurate
- Typing 45-50 WPM, keystroke, 6,000
- Reads, understands and follows applicable Standard Operating Procedures (SOP's), including safety and quality procedures
- Maintains clean and organized work area
- Restocks supplies as needed
- Participates in improving lab efficiency, quality and cooperation
Pharmacy Sales Associate
Wal-Mart Pharmacy
Forest Park
09.2016 - 01.2017
- Receive and fill prescription requests for patients by counting, pouring, and weighing medications
- Update a safe, effective, and clean pharmacy by complying with procedures and protocols
- Verify and enter patient and prescription information into computer using TASCO software and EPIC
- Translate and transcribe prescription data into corresponding system codes and create or modify patient records; strictly abide by all HIPAA regulations
Merchandiser
Sears
North Riverside
10.2011 - 04.2016
- Maintain stores shelves by observing displays of company products and providing optimum displays
- Assist with inventory functions and maintain awareness of floor stock; ensure strong customer service
- Printing over 1,000 signs weekly to ensure correct pricing
Education
Medical Office and Billing Specialist -
Ultimate Medical Academy
01.2016
Associate of Applied Science Degree - Criminal Justice
Everest University
01.2014
Skills
- Medical Billing
- Medical Office
- Medical Administrative
- Patient Registration
- Medical Terminology
- Medical Records Management
- Medical Practice Management Systems
- CPT Coding
- ICD-9-CM Coding
- ICD-10-CM Coding
- Charge Entry
- Payment Posting
- Denials
- Appeals
- Referrals
- Accounts Receivable
- Greenway
- Electronic Medical Records (EMR)
- Electronic Health Records (EHR)
- Insurance Verification
- Reimbursement Systems
- Healthcare Claim Cycle
- Healthcare Payers
- Managed Care
- Meaningful Use
- Medicare
- Medicaid
- Third Party Payers
- HIPAA Compliance
- Medical Charts
- Basic Anatomy & Physiology
- Healthcare Settings
- Computer Systems
- Software Applications
Certification
State of Illinois Pharmacy Technician Registration, 049245255
Academic Honors
- Academic Honors Recognition
- Honor Roll
Key Qualifications
- Medical Billing
- Medical Office
- Medical Administrative
- Patient Registration
- Medical Terminology
- Medical Records Management for the Billing Specialist
- Medical Practice Management Systems
- Introduction to CPT, ICD-9-CM, and ICD-10-CM Coding
- Charge Entry
- Payment Posting
- Denials
- Appeals
- Referrals
- Accounts Receivable
- Greenway
- Electronic Medical Records (EMR)
- Electronic Health Records (EHR)
- Insurance Verification
- Reimbursement Systems
- Medical Basics and Healthcare Claim Cycle
- Healthcare Payers
- Managed Care (HMO, PPO, and POS)
- Meaningful Use
- Medicare / Medicaid Government Payers
- Third Party Payers
- HIPAA Compliance
- Medical Charts
- Basic Anatomy & Physiology
- Healthcare Settings
- Computer Systems and Software Applications for the Medical Office
- Registration
- Receptionist
- Medical Records
Timeline
Senior Appeals Pharmacy Technician
Optum RX
09.2023 - Current
Patient Care Coordinator / Pharmacy Infusion Technician
Vitas Healthcare
08.2021 - 09.2023
Reference Coordinator (Send Out Lab)
Loyola University Medical Center
08.2020 - 08.2021
Core Processor (Support Service Tech)
Loyola University Medical Center
09.2018 - 08.2020
Overnight Specimen Processor (Data Entry Specialist)
Antech Diagnostics
01.2017 - 09.2018
Pharmacy Sales Associate
Wal-Mart Pharmacy
09.2016 - 01.2017
Merchandiser
Sears
10.2011 - 04.2016
Medical Office and Billing Specialist -
Ultimate Medical Academy
Associate of Applied Science Degree - Criminal Justice
Everest University