ADRINA GALAVIZ
Avondale
Overview
6
6
years of professional experience
1
1
Certification
Work History
Reimbursement Counselor (Financial Counselor)
CVS Specialty
07.2023 - Current
- Support patients in financial processes, boosting trust and satisfaction.
- Reduce claim processing time, improving patient satisfaction.
- Analyze financial data to enhance reimbursement rates.
- Coordinate with providers to resolve billing issues promptly.
- Maintain compliance with accurate patient records.
- Worked closely with Medicare, Medicaid, uninsured and underinsured patients.
- Process both medical and pharmacy claim.
- Process and adjudicate denial claims as needed.
Pharmacy Technician
CVS Specialty Mail Order
07.2021 - 06.2023
- Clarified prescriptions, ensuring accuracy and compliance.
- Resolved insurance issues, enhancing patient satisfaction.
- Entered prescriptions via phone, fax, eRX, and email.
- Manage multiple tasks to ensure timely medication dispensing.
- Coordinated communication for timely medication access.
- Process claims as needed.
- Worked closely with providers and pharmacists for any clerical discrepancies.
Intake Specialist
TotalMed - Lumicera Specialty
02.2021 - 07.2021
- Managed inbound calls for medication refills and authorizations, enhancing patient satisfaction.
- Coordinated with medical offices for timely medication deliveries, improving service efficiency.
- Created and maintained patient profiles, ensuring accurate and up-to-date records.
- Handled insurance and copay details, facilitating smooth transactions for patients.
- Collaborated with pharmacists to resolve issues, optimizing internal communication.
- Streamlined patient profile creation by integrating fax documents, ensuring comprehensive records for better care management.
- Provided insurance and copay assistance information, supporting patients in navigating their benefits for smoother medication access.
Pharmacy Technician Trainee
Walgreens
11.2019 - 02.2020
- Processing new patient registration by entering data into the appropriate system.
- Handling patient prescription requests within HIPAA guidelines and entering refill orders for processing.
- Troubleshooting to obtain missing prescription information and interpreting medical abbreviations (SIG codes).
- Resolving all data entry related exceptions.
- Resolving Third Party Rejects by reviewing, gathering information, making corrections, and resubmitting for processing according to individual plan requirements.
- Making telephone calls to insurers and others to obtain information, gain override approval, or otherwise resolve the Third-Party Rejects.
- Process retail claims and adjudications.
Education
High school diploma - undefined
Cesar Chavez High School
Laveen, AZ05.2017
Certificate - Medical Billing And Coding
Penn Foster College
Scottsdale, AZSkills
- Medical Office Experience
- Microsoft Outlook
- Prescription Entry
- DX Coding
- Medical claim processing
- Rx benefit claim processing
- Basic knowledge of QXNT
- Prescriber Engagement
- Problem Solving
- Attention to Detail
- Adaptability
- Insurance Verification
- Medical Terminology
- Microsoft Excel
- Data Entry
- HIPAA laws and procedures
- Team Lead Coaching
- Customer Service
- Time Management
- Team Collaboration
- Patient Care
- Interpersonal and written communication
- Claim investigation
- Knowledge of medical coding
- Billing and coding
Certification
- PHARMACY TECHNICIAN TRAINEE LICENSE
- Expires 01/31/2023
Timeline
Reimbursement Counselor (Financial Counselor)
CVS Specialty
07.2023 - Current
Pharmacy Technician
CVS Specialty Mail Order
07.2021 - 06.2023
Intake Specialist
TotalMed - Lumicera Specialty
02.2021 - 07.2021
Pharmacy Technician Trainee
Walgreens
11.2019 - 02.2020
High school diploma - undefined
Cesar Chavez High School
Certificate - Medical Billing And Coding
Penn Foster College