
Healthcare Operations & Data Processing Specialist
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I have over 19 years of experience in healthcare and specialty pharmacy operations, including eligibility verification, claims support, data review, customer support, and leadership responsibilities. I currently work in a lead role where I assist with workflow management, training, quality review, and supporting team operations.
I am highly detail-oriented, organized, and experienced working in fast-paced environments that require accuracy, multitasking, and problem-solving. I am comfortable working independently in remote environments, learning new systems quickly, and maintaining productivity while meeting quality standards. I am now looking for a remote opportunity where I can continue using my administrative, operational, and analytical skills to contribute to a strong team.
I currently work as an Eligibility Lead in specialty pharmacy operations, where I support workflow management, assist team members with escalations, monitor productivity and quality, and help ensure daily operational goals are met. I also serve as a Subject Matter Expert (SME) and TAP Trainer, assisting with training, onboarding, and process support for team members.
In my recent and previous roles, I have over 19 years of experience handling eligibility verification, insurance review, claims support, prior authorizations, data entry, documentation review, and customer account research in high-volume healthcare environments. My responsibilities have included reviewing detailed information for accuracy, navigating multiple systems, resolving issues, meeting productivity metrics, and maintaining compliance standards.
One of my biggest achievements has been growing into leadership and training responsibilities while consistently maintaining strong quality and performance standards. I have also helped support process improvements, assisted peers with complex cases, and adapted quickly to new systems and workflow changes in fast-paced remote and operational environments.
I have completed company-based training and ongoing professional development throughout my healthcare and specialty pharmacy career. My training includes eligibility verification, claims processing, insurance review, compliance procedures, customer support, quality assurance, workflow management, and specialty pharmacy operations.
I also serve as a TAP Trainer and Subject Matter Expert (SME), where I assist with onboarding, coaching, and training team members on systems, processes, and operational procedures. Through my experience, I have developed strong skills in data accuracy, multitasking, problem-solving, communication, and navigating multiple healthcare systems in fast-paced environments.
In addition to my hands-on experience, I continuously adapt to new systems, workflows, and technology to support operational efficiency and quality performance in remote and team-based environments.