Titika Palmer
Wake Forest,NC
Summary
Qualified and professional Behavior Therapist offering background working one-on-one in homes, schools and community to provide high-quality behavioral services to individuals with developmental disabilities. Addressed specific client needs based on individual treatment plan and collected data on treatment goals. Successfully reduced problem behaviors and increased functional replacement behaviors. Committed to enhancing autonomy and quality of life among individuals and families thorough proven treatment methods.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Behavior Therapist
Key Autism Services
04.2024 - Current
- Actively listen, communication, customer service, management, problem solving, attention to detail, extensive knowledge of Applied Behavioral Analysis approaches for children with Autism, skilled individualized therapeutic planning, experienced with counseling both individually and in group sessions, good understanding of associated sensory sensitivities, strong empathic listening skills, research, ethics, critical thinking, empathy, patience, observation, excellent interpersonal, social, and written communication abilities
Program Specialist I-Call Center
Trial Card
06.2023 - 01.2024
- Close current cases, obtain MI for insurance claim, calling payers for Medicare, Medicaid, other payers, faxing PA to providers, obtaining benefits for Data Check, placing cases in payer delay and following up daily, creating payer trend, using LCA forms for patients, using Sales forces systems, using CRM, using Teams, send emails, working from excel, using pivot, processing PA forms, verification of J-code, Dx codes, CPT codes, medical terminology, scheduling appointments for patients
- Managed outbound calls
- Emails
- Faxes
Reimbursement Case Manager-Contract-Remote
Aston Carter-Trial Card
04.2023 - 08.2023
- Pharmaceutical Drug Company, works with the Market Access Organization task helping HCP navigate reimbursement issues for the drug that FRM is supporting, attentiveness to detail, accuracy & possess organizational skills, coordination of resources with primary & secondary third-party payers, coding, coverage, & payment systems describing drugs, medical devices, surgical procedures, evaluate & modifies benefits policies, to ensure, that programs are current, competitive, & in compliance with legal requirements, analyze compensation policies, government, regulations, & prevailing compensation plans, prepare detail job description & classification systems & define job levels & families, in partnership with other managers, develop methods to improve employment policies processes, & practices, & recommend changes to management, negotiate bargaining agreements, conduct exit interviews to identify reasons for employee termination, active listening, assisting with the PCC role, using different systems to make sure patients receive medications on time, working with immunology, oncology, infectious disease, & cardiovascular patients, helping to make sure patients are enrolled into the correct Program that their insurance will cover under their commercial, or governments plan, intake, ensuring that patients meet the federal poverty level, running soft credit checks for patients to make sure customers qualify for certain programs, ensuring that patients receive their medication within a timely manner, reviewing patients PEF forms to enroll them in certain program, faxing forms or missing information over to the payor, FRSM, HCP, & the patient for MI, EOB, or additional information
Associate, Client Services
BNY Mellon Pershing Bank
12.2021 - 11.2022
- Updating client accounts, performing variety of tasks, responsible for managing time wisely, working alone, open accounts and updating daily accounts, de-escalating work that does not correct certain queue that's been assigned, document all opened and closed accounts that are being worked in certain queues, communicate with management using certain systems, or Jabar called Teams daily, multitask effectively, strong written and verbal communication skills, working on beneficiary's accounts, updating TOD accounts, managing New Accounts, managing Death Certificate accounts, managing Adoption accounts, managing Marin Agreement accounts, managing Joint Agreement accounts, updating New Profile accounts, managing re-indexed accounts, updating, updating Marriage Certificates, data management, bank custody cases, attend daily meetings in Teams
- Increased team productivity with effective communication and collaboration strategies.
- Managed a high volume of customer inquiries, demonstrating excellent problem-solving skills to resolve concerns quickly.
- Optimized resource allocation through effective scheduling, prioritization of tasks, and delegation of responsibilities among team members.
- Delivered outstanding customer support by providing prompt, courteous assistance during all interactions with clients.
- Improved workflow management by introducing time-saving tools and techniques that boosted employee productivity.
- Assisted in training new employees on company policies, procedures, and best practices to improve overall efficiency.
- Completed routine maintenance tasks efficiently, ensuring optimal equipment performance and minimizing downtime.
- Ensured compliance with safety regulations by conducting regular audits and implementing necessary improvements in the workplace.
- Strengthened client relationships through consistent follow-ups after service appointments.
Specialty Pharmacy Coordinator /Case Manager Staffing
McKesson/Remx
10.2021 - 10.2022
- Managing programs, leading Teams, accountable for initiatives with data, applying best practices, defining incremental breakdowns of the work for implementation, value delivery in an accelerated manner, tracking measurements against value articulated at the end of each cycle, primary point of contact for initiatives through implementation to realize the business case, providing support to create a solid concrete for collaboration with Business Owners, Product Managers, and Teams as needed, updating schedules, driving facilities, project decisions, structure agenda's, managing, driving, and following up to completion, plan meetings internal and events, as well as executes, detailed oriented and highly organized, strong ability to communicate effectively and influence, works well in a Team centered environment as well as the ability to work independently, 13 years of HealthCare experience is a plus, process design and efficiency, PAP referrals, Jabra, Teams, BI Investigations, HIPAA, Prior Auth, fax process, consent process, running test claims, reaching out to HCP office for shipping status for orders, processing prior auth, contacting Payors office to make sure Synagis was received by HCP office, completing ADV Events as needed, updating Excel Spreadsheet, completing 5nine report, completing Escalations, reporting all FRSM to Synagis Inbox every 2 hours
Pharmacy Technician
CVS Pharmacy
12.2018 - 05.2022
- Exceptional customer service skills, customer interaction critical key components, maintaining production, drop-off, pick up, drive through process, providing 1st fill process, counseling patients about prescriptions after filled as needed or other questions or concerns, adherence outreach, new prescription pick-up: reach out or consolidate prescriptions per patient request, ready refill services if it's offered per prescription & explain the process to patient, setup auto refill, explain the process to patient, setup patients' profile, text message for available prescriptions, demographic information updates, script sync, data entry per prescription while patients in store, provide patient with a TAT, provide patient with copay if there is a copay, provide patient with other options if insurance want cover medication, start prior auth if medications not covered by insurance, add insurance onto patients' profile, add a discount card onto patients' profile, reach out to the provider if the patient has no refills on file, sending fax over for additional refills, provide patients with short term supply if patients' out of medication & it's not a C2 medication, process the claim to make sure the claim processes through before providing patient with copay, following pickup process procedures, offering Pharmacy Health Benefits and Rewards, enrolling patients into Script sync Program, pharmacy immunizer, completing dosage, administration, frequency process according to the patient's prescription, explain to the patient when, where, how to take the medication, based upon the doctor's requirements, explaining coordinating benefits, following DEA Laws, expediting prescriptions based upon the system and promised to patient
Office Administration/QA Analyst
Conduent Corporation
03.2013 - 12.2021
- Hiring employees, training employees, monitoring calls, motivating agents to meet metrics, coaching agents, managing staff, setting certain goals for agents to meet as well as deadlines, greeting visitors, verifying agents' information, scheduling appointments for interviews, visitors, and vendors, supplying refreshments, making copies of plans, dependable, problem solving, works well under pressure, answering and forwarding calls, strong technology skills, time management skills, independent approach to work, research answers for customers diffuse complaints, Conduent/Humana Pharmacy, quality analyst, creating plans, meeting quality requirements, adhering to the organizations policies, implementing plans with errors to fix low performers, reliability, functionally, coaching low performs as needed, observing calls, demonstrating strong attention to details and analytical as well as problem solving, implementing quality assurance standards, provides accurate & comprehensive feedback, monitor scripts for certain functionally, provide corrective action if the same behaviors are repeated for low performers, meeting expectations, investigations customer complaints and product issues, strong computer skills and knowledge of QA, grade to mentor/QA guide, side by side with agents, live monitor agents and providing guidance to agents while live monitoring calls, calibration with other sites other than Raleigh, by Zoom, one on one coaching obtaining performance
Supervisor-Customer Experience IV
Conduent Corporation-Humana Pharmacy
03.2013 - 12.2021
- Demonstrates leadership through motivation, coaching, of team members to ensure successful operations, departmental targets, and company-wide goals, ensured team phone quality and key point targets stay consistent and accurate, all KIPs (Key performance Indicators) set by operations are met weekly, monthly, and yearly through successful implementation of S.M.A.R.T goals, implemented employee games and other strategic challenges to promote the success of employee appreciation, avoid shrinkage, and build morale across diverse cultures, created Excel pivot tables to help strategically track and measure team overall success rate, coached, trained employees on learning Health insurance benefits, using RxNova systems to process copays, processing PA (Prior Authorizations) and reporting AEs (Adverse Events) to Pharmacist to help improve customer satisfaction, and reduction in errors, ensure all team members to increase product knowledge of Humana- Medicare insurance benefits as it relates to Pharmacy, weekly team calibrations used to up train, report latest trends, and strategies for team suggestions, weekly team calibrations used to with SBI Manager, Operations Manager, Supervisors, and Workforce Management Team, guest & other Teams off-site struggling as well, provided problem solving to help support team members, agents, and others to analyze and research and resolve difficult Pharmacy related issues in a timely manner, de-escalate situational issues involving teams' members, responsible for hiring, terminating, payroll, and performing monthly evaluations, use Feps/Kronos payroll systems, intake fax process from My queue to have full ownership to send things over to agents, assigning certain Regions to agents, makings sure agents perform & meet goal per month based upon metrics/performances, assisting with Investigating Cases=BI/Benefit Investigation, processing claims to see the approval & denial reason assuring CSR/ process correctly, assisting CSR/agents with processing PA for patients, explanations for denials, demonstrating PAE/ Potential Adverse Event Cases, demonstrating Potential Adverse Event Recognition & Reports, demonstrating Approved NCCN or Not approved NCCN, using the main 3 DX codes to identify FDA approval, no approval, or NCCN, performing Stop/Unenroll Patient PAP process, working on Follow-Up Cases & making sure their assigned to the correct agent, coding & billing process, faxing documents to the appropriate department, checking patients consent form for clarification as needed, working on FDA on label/ off label approvals & not approvals, steady state BI's 24-48 hours important case's high priority, notes processed correctly in system using note generator, notepad, or one note, provider calls, CIW/Clinical Intake Worksheet Form Process, insurance/Pharmacy Call according to BI process, preliminary benefits process as needed, Marrs Links, payer type information processed as needed, PAP referral process, diagnosis codes, J-Codes, reimbursement & coverage for patients, coordination of benefits, CPT administration codes, NCD codes, ICD-10 code, HCPCS product treatment code, processing appeals triaging enrollment forms, processing ACT enrollment forms, monitor performance results to identify and act on positive and negative trends for a team of 30 to 35 agents, monitor service calls to observe employee behaviors to ensure performance targets are met, per client policy, ensures customer needs are met including payment refunds, medication arrival, and any account issues, completing enrollment forms, coding and billing process
Education
High School Diploma -
James Madison High School
Atlanta, GA08.2007
Skills
- Calibration
- HIPAA
- Medical Terminology
- Administrative Experience
- Event Planning
- Medical Records
- Negotiation
- EMR Systems
- Process Improvement
- Presentation Skills
- Data Entry
- CRM Software
- Salesforce
- Case Management
- Epic
- CPT Coding
- ICD-10
- Management
- Program Management
- Medical Office Experience
- Supervising Experience
- Quality Assurance
- Employee Orientation
- ICD-9
- Pharmacy technician experience
- Medical billing
- Recruiting
- VPN
- Live chat
- Remote recruiting
- Quickmar
- Quality audits
- Microsoft Excel
- Leadership
- Customer service
- Account Management
- Relationship Building
- Crisis intervention strategies
- Autism Spectrum Knowledge
- Social Skills Training
- Prompting Strategies
- Cognitive behavior therapy
- Self-Management Support
- Visual Supports Implementation
- Coping skills development
- Group therapy facilitation
- Collaborative Problem-Solving
- Sensory integration techniques
- Behavioral Interventions
- Applied Behavior Analysis
- Motor Skills Development
- Verbal Behavior Approach
- Error Correction Techniques
- Task Analysis Development
- Transition Planning Assistance
- Developmental delays experience
- Autism Spectrum Disorder
Certification
- CPR Certification
- AED Certification
- Pharmacy Technician License
- Certified Behavioral Health Technician
- Board Certified Autism Technician
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Behavior Therapist
Key Autism Services
04.2024 - Current
Program Specialist I-Call Center
Trial Card
06.2023 - 01.2024
Reimbursement Case Manager-Contract-Remote
Aston Carter-Trial Card
04.2023 - 08.2023
Associate, Client Services
BNY Mellon Pershing Bank
12.2021 - 11.2022
Specialty Pharmacy Coordinator /Case Manager Staffing
McKesson/Remx
10.2021 - 10.2022
Pharmacy Technician
CVS Pharmacy
12.2018 - 05.2022
Office Administration/QA Analyst
Conduent Corporation
03.2013 - 12.2021
Supervisor-Customer Experience IV
Conduent Corporation-Humana Pharmacy
03.2013 - 12.2021
High School Diploma -
James Madison High School
- CPR Certification
- AED Certification
- Pharmacy Technician License
- Certified Behavioral Health Technician
- Board Certified Autism Technician
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