Dr.Lakennia T. Terry

• Process and manage reimbursement claims for specialty pharmacy services, ensuring accurate billing and timely payment in compliance with insurance and payer guidelines.
• Verify insurance benefits, initiate prior authorizations, and follow up on unpaid or denied claims to maximize revenue cycle performance.
• Utilize CMM and Nexus systems to track patient financial records, manage account balances, and ensure HIPAA compliance in all communications.
• Collaborate cross-functionally with pharmacists, providers, and payers to resolve complex reimbursement issues and improve patient access to therapies.
• Maintain up-to-date knowledge of payer policies, coding requirements, and pharmacy billing regulations to ensure accuracy and minimize delays.
• Provide excellent patient and provider support with empathy and efficiency in a fast-paced remote environment.

• Assist in Level 1 trauma cases, maintaining sterile environments and ensuring proper instrumentation availability for surgical procedures.
• Provide Direct support to surgeons during preparation, intraoperative, and emergency operations, ensuring efficiency and precision.
• Adhere strictly to operating room protocols, maintaining compliance with safety and procedural standards to optimize patient outcomes.
• Prepare and organize the sterile field, including selecting, preparing, and arranging surgical instruments, supplies, and equipment.
• Facilitate efficient turnover between cases by cleaning and sterilizing surgical instruments and equipment, adhering to infection control standards.
• Collaborate with the surgical team to anticipate needs during procedures, ensuring timely availability of instruments and supplies.
• Conduct preoperative checks of surgical equipment to ensure functionality and prevent procedure delays.
• Maintain accurate documentation of surgical counts, equipment usage, and patient information for records and compliance.
• Provide postoperative assistance, including dressing application, equipment breakdown, and preparation for subsequent cases.

• Monitored workflows and assisted in task assignments for the billing collections team.
• Handled escalated cases, including reverse and rebills and critical payer issues.
• Provided training, onboarding, and mentorship for new and existing team members.
• Conducted chart note and payer audits, ensuring compliance and accuracy.
• Acted as a liaison between operational departments to resolve member and payer issues.
• Authored and updated Standard Operating Procedures (SOPs) for departmental processes.

• Verified patient insurance eligibility and drug benefits within strict deadlines.
• Processed billing claims through secondary copay assistance programs.
• Obtained and coordinated prior authorizations with payers and physicians.
• Reviewed benefit plan designs and clinical criteria to ensure seamless claim approvals.

• Specialized in Spinraza (treatment for spinal muscular atrophy) and other rare neuromuscular disorder medications.
• Managed complex payer communications and assisted patients with understanding billing and assistance programs.

• Managed limited distribution drugs, including Gilotrif, Tagrisso, and Lenvima.
• Coordinated prior authorizations and processed claims for secondary assistance programs.
• Educated patients on account details, ensuring clarity and resolution of billing issues.

• Managed insurance verifications, coding, and billing tasks to ensure accurate processing.
• Supported medical teams by collecting vital signs and preparing patients for examinations.

• Processed billing for missing surgical instruments and spinal implants.
• Handled product complaint entries and facilitated returns for inventory reconciliation.

· Performed general office duties including data entry, order entry, customer service, and switchboard

· Billed for missing instruments and spinal implants used in spinal surgeries.

· Researched damaged returns

· Researched mixed, partial, and unidentified loaner sets by tracking late or lost loaner sets through FedEx

· Created Return Authorizations for missing items

· Researched Missing/ Disputed unbilled instruments and implants to reconcile and clear unbilled report

· Reimbursed for returned instruments and unused spinal implants after completing research process

· Invoiced Missing Instruments and notified Sales Reps/Office Coordinators of Missing Instruments through COGNOS System

· Maintained Access database and created Excel spreadsheets

· Utilized SAP (R/3) and JD Edwards Systems to generate missing instrument report, research

· Maintained Access database and created Excel spreadsheets