A'laya Payne

• Directly communicate with insurance companies to facilitate the approval of medications.

• Navigate pharmacy operating systems to input data, perform adjudication on test claims and prepare action plans for follow-up.

• Effectively communicate across databases, electronic medical records and emails to document patient concerns, prior authorization status, and financial assistance needs.

• Review prescriptions with doctors' offices to ensure optimal care of the patient.

• Keep complete and accurate records of patient communications.

• Assist patients in the management of their pharmacy insurance claims.

• Work closely with pharmacists and pharmacy liaisons to provide an integrated approach quality patient care.

• Communicate directly with patients over the phone to assist them in all aspects of medication compliance.

Research and investigate information to enable strategic decision-making by others.

• Manage, organize, and update relevant data using database applications.

• Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.

• Identify trends, resolve problems; recommend improvements; implement change.

• Actively participate in process improvement initiatives.

• Act as a value-added business partner to stakeholders throughout the organization.

• Protect organization's value by keeping information confidential.

• Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.

• Perform other duties as assigned.

• Facilitated insurance verification and processed third-party claims to ensure efficient prescription access.
• Reviewed and resolved prior authorization requirements with insurers and prescribers to support patients.
• Documented communications in pharmacy systems, escalating high-cost medication issues to pharmacists.
• Advised patients on copay options and formulary alternatives for enhanced medication management.
• Interpreted and processed medication orders under pharmacist supervision to ensure accuracy.
• Participated in pharmacy inventory management, tracking expiration dates and removing outdated medications.
• Compiled customer demographic data, allergy information, and medical history for comprehensive patient profiles.
• Received written prescription or refill requests, verifying completeness and accuracy of submitted information.

• Processed an average of 400 prescriptions daily with 98% accuracy.
• Verified order accuracy prior to deliveries to ensure customer satisfaction.
• Assisted with technology troubleshooting and system updates for efficient claim resolution.
• Maintained comprehensive documentation of claim statuses and patient outreach efforts.
• Communicated shipment status updates effectively to customers to enhance transparency.
• Provided empathetic phone support to patients regarding medication delays and financial options.
• Collaborated directly with physicians and insurance providers to resolve cost discrepancies.
• Participated in continuing education and training to stay current with pharmacy practices and technology.

• Processed payments for prescriptions and addressed insurance-related inquiries efficiently.
• Provided administrative support through phone triage, data entry, and patient file updates.
• Assisted customers with over-the-counter recommendations and scheduling prescription refills.
• Maintained cleanliness of work environment by promptly cleaning spills and disposing of waste.

• Facilitated front-end assistance by addressing patient inquiries about medications and pharmacy products.
• Supported prescription pickups while ensuring accuracy of patient data.
• Executed point-of-sale transactions efficiently with cash registers.
• Conducted data entry in pharmacy software for prescriptions and patient profiles.
• Verified patient demographics and insurance information to confirm accuracy of prior authorization requests.