Healthcare Virtual Assistant | Registered Pharmacist

I handle accurate data entry for patient records, insurance information, claims details, and prior authorization documentation. I work with EHR systems, insurance portals, and internal databases to ensure all information is complete, accurate, and organized. I maintain a high level of attention to detail and follow HIPAA guidelines when entering and managing sensitive patient data.

I process claim submissions for major vision insurance providers such as EyeMed, Spectera, Davis Vision, and Superior Vision. My tasks include entering accurate patient and service information, reviewing coverage details, uploading required documentation, and confirming successful claim transmission. I also monitor claim statuses, identify issues, and ensure timely and accurate reimbursement.

I follow HIPAA guidelines when handling patient information, insurance data, medical records, and communication. I ensure that all sensitive data is kept confidential, securely stored, and only shared with authorized parties. My work in EHR management, insurance verification, claims processing, and prior authorizations is performed with strict adherence to privacy and security standards.

As a licensed pharmacist, I have a solid foundation in medication therapy, drug classifications, dosing, interactions, and clinical decision support. My background allows me to accurately review prescriptions, understand treatment plans, and communicate effectively with healthcare providers, pharmacies, and patients regarding medication-related concerns.

I handled outbound calls to pharmacies and healthcare provider offices to support patient medication adherence and refill coordination. My responsibilities included confirming prescription pickups, verifying refill needs, addressing barriers to adherence, and assisting providers with medication-related questions. I ensured clear communication between patients, pharmacies, and healthcare teams to support continuity of care.

I manage patient information within EHR systems by updating charts, entering insurance details, documenting visit notes, and reviewing records for accuracy. I have experience using platforms such as Compulink and Practice Fusion. I maintain confidentiality and ensure all entries follow HIPAA and clinic documentation standards.

I verify patient insurance by checking eligibility, coverage details, copays, deductibles, and plan limitations. I primarily use Availity and ABB Verify, and when needed, I review information directly through individual payer portals. I ensure accurate insurance information before appointments to prevent claim issues and support smooth clinic operations.

I handle medical insurance verification using Availity as my primary platform, checking eligibility, benefits, copays, deductibles, and prior authorization requirements. When information is not available through Availity, I access individual payer portals to complete the verification. I am experienced in reviewing coverage details for plans such as UHC, UMR, Aetna, Blue Cross Blue Shield, Meritain, and Tricare. My work ensures accurate insurance information before patient appointments and supports smooth clinic operations.

I process prior authorizations for ophthalmic medications using CoverMyMeds. My tasks include reviewing diagnosis codes, confirming insurance requirements, gathering clinical information, and submitting requests for approval. I also track the status of each PA, respond to payer clinical questions, and update patients regarding their PA paperwork and status through SolutionReach. This ensures clear communication, timely approvals, and smooth patient care.