MS
Open to opportunities

Mandy Smith

@mandysmith

Experienced healthcare reimbursement professional with expertise in specialty pharmacy.

United States

What I'm looking for

I am looking for a role that allows me to leverage my reimbursement expertise while contributing to patient access solutions in a collaborative environment.

I am a seasoned healthcare reimbursement professional with extensive experience in specialty pharmacy, payer policy research, and patient access solutions. My career is distinguished by a consistent record of successfully addressing complex reimbursement issues and enhancing payer compliance. I am committed to improving patient outcomes through effective problem-solving and operational excellence.

In my most recent position, I focused on full-time medical coding studies. Prior to that, as a Reimbursement Specialist at Genentech, I established and maintained a comprehensive internal payer database, which significantly enhanced cross-functional efficiency and the accuracy of payer policies. My initiatives resulted in a 10% increase in prior authorization approval rates, reflecting my ability to foster collaboration among teams and streamline processes.

Throughout my career, I have been dedicated to facilitating access to healthcare for under insured patients and ensuring equitable treatment options. My roles as a Case Manager and Insurance Specialist have provided me with the skills necessary to educate patients about their insurance coverage, secure prior authorizations, and enhance patient satisfaction scores. I am passionate about utilizing my expertise to create a meaningful impact within the healthcare industry.

Experience

Work history, roles, and key accomplishments

WH
Current

Operations & Customer Relations Coordinator

Wolfs Head

Jul 2023 - Present (1 year 10 months)

Oversaw front-end operations and managed customer interactions, contributing to the successful launch of a new restaurant while balancing full-time medical coding studies.

GS

Case Manager (Ophthalmology)

Genentech Access Solutions

Sep 2019 - Jul 2023 (3 years 10 months)

Facilitated access to financial assistance programs for underinsured patients, ensuring equitable access to treatments and guiding patients through reimbursement procedures.

GS

Reimbursement Specialist (Neurology)

Genentech Access Solutions

Apr 2020 - Jul 2023 (3 years 3 months)

Designed and maintained a comprehensive internal payer database, improving cross-functional efficiency and payer policy accuracy. Increased prior authorization approval rates by 10% through process optimization.

RG

Insurance Specialist

Reproductive Partners Medical Group

Oct 2018 - Oct 2019 (1 year)

Streamlined access to fertility treatments by educating patients on insurance coverage and securing prior authorizations, improving patient satisfaction scores by 15%.

TC

Reimbursement Specialist

Tandem Diabetes Care

Sep 2018 - Oct 2018 (1 month)

Processed claims for durable medical equipment, recovering approximately $100,000 in denied claims through successful appeals and payer negotiations.

Education

Degrees, certifications, and relevant coursework

San Francisco State University logoSU

San Francisco State University

Bachelor of Arts, Biology

Bachelor of Arts in Biology with a minor in Holistic Health.

Tech stack

Software and tools used professionally

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