Renee Macaulay

Detail-oriented Patient Service Representative with over 30 years of experience in data entry and document processing, seeking to contribute strong administrative, communication, and customer service skills. Committed to maintaining accurate patient records, supporting efficient office operations, and delivering a professional and compassionate patient experience.

Patient Service & Program / Medicaid Billing Representative - Cencora

(1988-12 - 2026-04)

A global pharmaceutical solutions and healthcare services company formerly known as AmerisourceBergen.

• Assisted patients with enrollment in Prescription Assistance Programs (PAPs) to obtain affordable medications in various medical specialties
• Verified patient eligibility requirements including income, insurance coverage, and residency documentation
• Completed and submitted PAP applications accurately and within required deadlines
• Coordinated with healthcare providers, pharmacies, and pharmaceutical companies regarding medication assistance requests
• Maintained confidential patient records in compliance with HIPAA regulations
• Followed up on pending applications, renewals, and medication shipment statuses
• Educated patients on available medication assistance resources and program requirements
• Answered high-volume inbound and outbound calls regarding prescription assistance and patient support services
• Obtained prior authorizations and insurance verification when required for medication access
• Documented patient interactions and case updates in electronic medical record (EMR/EHR) systems
• Assisted patients in resolving medication access issues, denied applications, and coverage concerns
• Monitored renewal dates to ensure uninterrupted medication assistance for eligible patients
• Collaborated with case managers, social workers, nurses, and providers to improve patient access to medications
• Managed multiple cases simultaneously while maintaining accuracy and attention to detail
• Provided compassionate customer service to patients experiencing financial hardship or healthcare access barriers
• Resolved claim rejections and adjudicate paid claims to payers
• Managed patient accounts and maintained over 100 weekly accounts
• Run daily phone stats reports for management
• Assign new PAP cases daily to team members
• Billing and Collections for various government insurance payers
• Process underpayments, denials and overpayments
• Denial resolution
• Provide system training to new employees
• Accounts Receivable review