Summary
Overview
Work History
Education
Skills
Timeline
Generic

Candice Oakes

Pittsburgh

Summary

Dynamic and motivated entry-level professional eager to embark on a new career path, equipped with strong problem-solving and communication skills. Detail-oriented with a commitment to enhancing production processes through hands-on experience and a proactive approach to learning and development. Prepared to leverage a passion for continuous improvement and collaboration in a fast-paced environment. Seeking to contribute effectively to team goals while gaining valuable industry insights.

Overview

11
11
years of professional experience

Work History

Inventory specialist

Insight Global
06.2025 - Current
  • Proficient in inventory management software
  • Strong attention to detail
  • Excellent organizational skills
  • Ability to work in a fast-paced environment
  • Knowledge of supply chain management principles
  • Strong communication skills
  • Ability to analyze data and identify trends
  • Experience with cycle counting and inventory reconciliation
  • Ability to prioritize and multitask effectively
  • Knowledge of inventory control best practices

Laboratory Operator

Emerald Cloud Laboratory
03.2024 - Current
  • Ability to work safely in a laboratory environment. Chemical Handling, PPE, Trained in safety equipment.
  • Ability to work safely with general laboratory equipment (Heat blocks, incubators, Cryostores, instruments with magnetic fields)
  • Experience in use of common laboratory equipment. (Pipettes, Mico and general balances, centrifuge, vortex, mixers, sample imagers, liquid level detectors)
  • Trained in Biosafety Cabinets (Aseptic techniques, Disinfection procedures, Workplace organization)
  • Experienced in the operation, maintenance, and qualification of specific laboratory instrumentation (High Performance Liquid Chromatography-HPLC, Liquid Chromatography/ Mass Spectrophotometry-LCMS, Nuclear Magnetic Resonance-NMR, X-Ray Crystallography, Automated Liquid Handlers-Hamilton, Automated Thermal Cyclers
  • Proficient in a vary of information systems (Laboratory information Management System- LIMS; ECL Engine, Workplace communication and direct messaging- SLACK, Google Suite
  • Demonstrated competence with general laboratory and workspace functions (Inventory management and control of specimens and reagents.
  • Shipping and Receiving, Active troubleshooting of system and instrument failures, Accurate maintenance of various records and logs

Mail Room Clerk

SPS/Insight Global
12.2023 - 02.2024
  • Separates and delivers mail for delivery to distribution areas within BNY Mellon Downtown.
  • Delivers mail to correct departments, and picks up any outgoing mail.
  • Sorted outgoing letters and packages according to destination and type.
  • Weighs outgoing mail to determine the cost if weight exceeded the normal weight.
  • Personally delivers mail or packages to person if signature is required.

Caregiver for my mother who was terminally ill

09.2023 - 11.2023

Reimbursement Specialist

Caremetx
04.2023 - 09.2023
  • Experience working in the healthcare industry or accounts receivable field.
  • Verifies new and existing patients have necessary referral and/or authorization documentation prior to examination date.
  • Verifies patient demographics and insurance providers, updates information in systems, and documents conversations.
  • Demonstrate knowledge of state & federal collections guidelines.
  • Experience in medical billing, medical insurance verification, managed care and/or patient registration required.
  • Demonstrates knowledge of health insurance plans including Medicare, Medicaid and commercial carriers.
  • Investigated and verified all insurance claims for Major medical, Medicare, and Medicaid.
  • Issued payment or dismissal notices.
  • Accurate compliance with local, state and federal regulations and company policies.
  • Prepairing reports on investigation, settlements, denials of claims, individual evalution of individual parties, etc.
  • Consistent professional behavior and ability to handle confidential information.
  • Able to work independently, prioritizing and organizing workload effectively to complete tasks within the timeframes delegated.
  • Contact insurance companies to verify primary and secondary insurance coverage for both in-network and/or out of network physical therapy benefit coverage.

Sr. Reimbursement Representative

Insight Global- UBC
12.2022 - 03.2023
  • Ensures insurance coverage by telephone.
  • Resolves any issues with coverage and escalates complicated issues to management.
  • Coordinates with clinical staff to obtain compliance.
  • Codes procedures performed and diagnosis on charge.
  • Assigns appropriate ICD-9, ICD-10, CPT and HCPCS codes to accurately support the need and documentation for each service.
  • Resolves routine patient billing inquiries and problems.
  • Verified benefits for Major medical, Specialty Pharmacy, and Pharmacy benefits, as well as followed up on Prior Authorization.
  • Worked closely with Medicare, and medicaid patients, and providers.
  • Verifies benefits for Major Medical, Specialty Pharmacy, and Retail Pharmacy Benefits.

Case Manager/data entry

ConnectiveRX - Endo Advantage, and JazzCares
04.2019 - 11.2022
  • Manages the Care Coordination process within an assigned territory while balancing the needs of individual patients and physicians with the business realities and necessities of the program.
  • Assesses physicians’ needs and develops action plans that provide for the introduction of therapy while coordinating the exchange of all patient-related information with internal and external customers.
  • Had an assigned region that I was responsible for, working closely with Field Reimbursement Manager.
  • Assists in obtaining insurance approval for therapy, and proactively plans to mitigate delays in coverage by working with the patients and their family, healthcare providers, insurance companies, and specialty pharmacies.
  • Exhibits a leadership role within the assigned territory. Able to consistently identify complex patient specific issues and develop action plans accordingly. Demonstrates accountability for action plan execution, and energetically drives for success and results.
  • Consistently maintains accurate data on each individual, their insurance, coverage approvals, on-going coverage requirements and all patient and provider interactions. Coordination of information with all customers is required.
  • Obtains insurance information necessary for various clinical services or procedures. Also works with Assistance Programs and enroll if eligible. Follow up with Prior Authorizations and Appeals.
  • Effectively shares reimbursement and other knowledge with patient care team members through orientation training, case studies, consultation for complex cases and special projects as requested.
  • Verified benefits for Major medical, Specialty Pharmacy, and Pharmacy benefits, as well as followed up on Prior Authorization.
  • Worked closely with Medicare, and medicaid patients, and providers.
  • Investigated and verified all insurance claims for Major medical, Medicare, and Medicaid.
  • Issued payment or dismissal notices.
  • Processing claims and reimbursement for Copay Assistance, and Patient asssistance programs.
  • Accurate compliance with local, state and federal regulations and company policies.
  • Prepairing reports on investigation, settlements, denials of claims, individual evalution of individual parties, etc.
  • Quality Assurance training.
  • Supervisor training.

Benefit verification representative/Case manager

Lash Group
08.2018 - 04.2019
  • Ensured accurate data entry into healthcare verification applications.
  • Entered pertinent information in a timely manner while paying special attention to detail.
  • Complied with federal regulations, including HIPAA provisions.
  • Examined pertinent information to determine the accuracy of client requests and related paperwork.
  • Maintained and revised procedural lists, control records and coded schemes to process source data.
  • Supported and complied with all company policies, processes and procedures including the Compliance Program and the Code of Conduct.
  • Reviewed and resolved discrepancies in received data and performed data verification routines in accordance with company procedures.
  • Verified benefits for Major medical, Specialty Pharmacy, and Pharmacy benefits, as well as followed up on Prior Authorization.
  • Worked closley with Medicare, and medicaid patients, and providers.
  • Assured that all requirements necessary are present per insurance verification.

Customer Care Coordinator

Alliance RX Walgreens Prime Specialty Pharmacy
02.2018 - 08.2018
  • Managed order entry workload so that orders were entered the day received.
  • Completed specialty medication Refill orders for Patients and Doctor Office’s.
  • Coordinated orders with production and logistics to ensure on time and complete to customers. Addressed incoming customer inquiries and offered productive solutions that increased customer satisfaction.
  • Assisted consumers with questions regarding our product.
  • Advocated for customers in improving availability and delivery.

Benefits Verification Coordinator

Kelly Services/ AmerisourceBergen
01.2017 - 02.2018
  • Ensured accurate data entry into healthcare verification applications.
  • Entered pertinent information in a timely manner while paying special attention to detail.
  • Complied with federal regulations, including HIPAA provisions.
  • Examined pertinent information to determine the accuracy of client requests and related paperwork.
  • Maintained and revised procedural lists, control records and coded schemes to process source data.
  • Supported and complied with all company policies, processes and procedures including the Compliance Program and the Code of Conduct.
  • Reviewed and resolved discrepancies in received data and performed data verification routines in accordance with company procedures.
  • Assured that all requirements necessary are present per insurance verification.

Shift Supervisor

Rite Aid
01.2016 - 01.2017
  • Oversee 5-8 employees work in the front end of store to ensure compliance with company policies, regulations, and safety guidelines.
  • Supervising employees in their duties and providing advice and customer assistance when required.
  • Performing cash management tasks, including counting money in registers and making bank deposits.
  • Unloaded the truck every week for stock.
  • Ensured that the building was fully secured after night shifts.

Customer Service Representative

Beacon Hill Temp Agency/ Jones Lang Lasalle
01.2015 - 01.2016
  • Enter new load information into the system quickly and accurately.
  • Calculate transit times and deliver information to customers.
  • Build relationships with customers to positively represent the company and encourage return of business.
  • Strong Interpersonal communication skills.
  • Deep knowledge and practice in banking company.
  • Process customer orders by data entry into computer system; verify accuracy prior to customer leaving station.

Education

High school -

Carrick High school
01.2008

Skills

  • Attention to detail
  • Customer service
  • Inventory control
  • Teamwork and collaboration
  • Leadership experience
  • Implemented process improvements
  • Adaptability and Flexibility
  • Emotional intelligence
  • Creativity and Innovation
  • Conflict resolution and Negotiation

Timeline

Inventory specialist

Insight Global
06.2025 - Current

Laboratory Operator

Emerald Cloud Laboratory
03.2024 - Current

Mail Room Clerk

SPS/Insight Global
12.2023 - 02.2024

Caregiver for my mother who was terminally ill

09.2023 - 11.2023

Reimbursement Specialist

Caremetx
04.2023 - 09.2023

Sr. Reimbursement Representative

Insight Global- UBC
12.2022 - 03.2023

Case Manager/data entry

ConnectiveRX - Endo Advantage, and JazzCares
04.2019 - 11.2022

Benefit verification representative/Case manager

Lash Group
08.2018 - 04.2019

Customer Care Coordinator

Alliance RX Walgreens Prime Specialty Pharmacy
02.2018 - 08.2018

Benefits Verification Coordinator

Kelly Services/ AmerisourceBergen
01.2017 - 02.2018

Shift Supervisor

Rite Aid
01.2016 - 01.2017

Customer Service Representative

Beacon Hill Temp Agency/ Jones Lang Lasalle
01.2015 - 01.2016

High school -

Carrick High school

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Candice Oakes