Honor Society® member
Shantell Gray
Eligibility Representative at Cigna • Performs medical/pharmacy benefit verification • Responsible for cross-functional resolution of drug coverage issues • Research and resolve drug coverage issues leading to financial assistance for patients • Performs insurance review on day of shipment to ensure insurance criteria is met to reduce the risk of bad debt. • Collaborates with internal departments to resolve issues or provide any needed information using professional communication. • Uses discretion and independent judgement in handling patient complaints and escalates to leadership as appropriate. • Does additional training to ensure successful production in other department functions
- healthcare management
- Class of 2025
- USA
Member since January 2024
About
Hello readers!
I have learned many things in my years of healthcare experience. Some of those lessons include how to use constructive criticism and be coachable, how to put my clients/patients needs at the forefront of my duties, and how to communicate effectively with my colleagues to create a dynamic work environment that focuses on our patients/members. In all of the lines of work that I've done people and their satisfaction were the focus, and most of the time the conversations ended with the patient/client being happy and me solving a problem. Situations such as these led me to be the person I am today - an empathetic listener, a problem solver, and a leader.
I am currently furthering my education in Healthcare Management so that I can be an effective leader and direct or manage a healthcare facility.
Education
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University of Alabama at Birmingham
Healthcare Management/Health Information Management
2021 – 2025
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Independence University
Associates of Occupational Studies in Medical Specialties
2017 – 2019
Goals and interests
- Career goal
Healthcare Manager/Administrator
Healthcare Director
Experience
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Eligibility Representative
Cigna • Performs medical/pharmacy benefit verification • Responsible for cross-functional resolution of drug coverage issues • Research and resolve drug coverage issues leading to financial assistance for patients • Performs insurance review on day of shipment to ensure insurance criteria is met to reduce the risk of bad debt. • Collaborates with internal departments to resolve issues or provide any needed information using professional communication. • Uses discretion and independent judgement in handling patient complaints and escalates to leadership as appropriate. • Does additional training to ensure successful production in other department functions
Mar 2022 – Feb 2024
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pharmacy technician
Community Health Systems - Contract (Monoclonal Antibody Clinic) ● Accepted inbound phone calls from physicians at various clinics to schedule patient appointments ● Prepped paperwork for patient appointments and assisted nurses in preparing for patient arrival ● Prepared infusion medication for clinic with pharmacist direction ● Maintained accurate count and quality of inventory to ensure needs of community were met
Oct 2021 – Jan 2022
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Pharmacy Technician
Prime Therapeutics ● Verified member eligibility for services ● Processed prescription claims to insurers to ensure coverage and compliance ● Verified accuracy and completion of claim and member information ● Reviewed, approved, or denied claim for pharmaceuticals based on processing information. Obtained additional information as required for insurance approval so order could be fulfilled. ● Managed time to ensure prescriptions were filled in timely manner ● Completed additional training to ensure successful production in other department functions
Oct 2021 – Oct 2022
Languages
- English (US) Fluent
