Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Alicia Lansdell

Tampa

Summary


Pharmacy professional with proven ability to manage pharmacy operations and ensure regulatory compliance. Known for fostering collaborative team environments and consistently achieving operational goals. Possesses strong skills in medication dispensing, inventory management, and patient interaction, with reliable and adaptable approach.

Overview

25
25
years of professional experience
1
1
Certification

Work History

Lead Pharmacy Technician

CVS Pharmacy
10.2023 - Current


  • Helped maintain a clean and organized workspace for optimal efficiency during high-volume periods.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Promoted teamwork among pharmacy staff, fostering a collaborative environment for improved productivity.
  • Resolved non-routine issues like third-party billing, computer system, and customer service issues.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Maintained and updated patient records, prescription information and patient data in accordance with HIPAA regulations.
  • Supervised junior technicians, providing guidance on best practices in pharmaceutical processes and procedures.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
  • Maintained compliance with all federal and state regulations related to pharmaceutical operations, ensuring accurate record-keeping and documentation practices.
  • Enhanced pharmacy efficiency by streamlining prescription processing and medication dispensing procedures.

Recovery Specialist

Sanderson Firm
05.2022 - 03.2023
  • I was responsible for drafting appeals and disputes to Traditional Medicare contractors (i.e., Commercial Repayment Center and Benefits Coordination & Recovery Center), the U.S. Department of the Treasury, debt collection agencies, Medicare Advantage Plans, and Prescription Drug Plans regarding conditional payment liens. This position requires a high degree of quality with a particular focus on attention to detail.
  • Basic Functions:
  • Investigate new conditional payment referrals, which includes initiation of Medicare lien search.
  • Analyze Medicare conditional payment correspondence to determine whether the reported injuries are related to the claim.
  • Draft disputes and appeals to submit to the appropriate Medicare entity.
  • Perform Medicare Eligibility Inquiries and Verifications as needed.
  • Triage conditional payment correspondence to the file upon receipt.
  • Monitor Medicare Secondary Payer Recovery Portal to secure updates relative to conditional payments.
  • Regularly communicate with management regarding status of appeals and provide any other additional support as needed.

Clinical Coordinator and QC

Optum (formerly Health Advocates)(formerly PMSI Settlement Solutions)
02.2015 - 05.2022
  • The Clinical Coordinator position is responsible and charged with all aspects of the delivery of Pre Settlement products to clients. This responsibility will include but not be limited to file acknowledgements, file intake, handling email/correspondence/phone calls, document creation/file review, and calculation of pricing and overall efficiency in workflows. This position is responsible for overseeing the creation and delivery of our clinical products as well as follow up and up-sell for additional products.
  • Basic Functions:
  • Promotes customer service by establishing and maintaining efficient workflows for Pre Settlement products to ensure timely delivery of a unique, quality product according to Settlement Solutions standards and customer specifications.
  • Works with management to monitor, evaluate and create efficient workflows for Pre Settlement products.
  • Studies, analyzes and interprets complex instructions while balancing and prioritizing multiple projects. Manage the DirectConnectCCCR Inbox. Including sending the completed Pre Settlement product to the client and managing incoming requests.
  • Manage follow up (diary) for all the Pre Settlement files.
  • Contact clients for up-sell of additional Pre Settlement products, such as Peer Outreach and NPM once initial clinical review is performed.
  • Send Physician Agreement Letters for signature; provide follow up and track success rate. Assure proper formatting and consistency of all Pre Settlement products.
  • Serve as liaison between Clinical and Settlement Solutions. Responsible for resolution of any procedural or individual file issues between departments.
  • Determine proper pricing and calculate savings for all Pre Settlement products.
  • Review Pre Settlement files/report for accuracy. Ensure RN oversight/review is provided on pre settlement files as needed.
  • Maintain Client Profiles, MRA and Clinical 360 screens for Pre Settlement products. Request client invoices. Review vendor invoices for accuracy.
  • Responsible for overall Quality Control of the administrative staff and Sales staff. Uses out of the box thinking as well as Quality Control scores to improve on processes and procedures in addition to identifying training issues.
  • Promotes customer service by establishing and maintaining quality control standards and checkpoints, monitoring the progress of all cases to ensure work is being completed according to Optum standards and customer specifications.
  • Works with management to create efficient workflows for top quality assurance of files. Reports all quality and training issues to management and assists with developing effective solutions.
  • Participates in training sessions (group or individual) for associates as needed.
  • Works with management on projects when selected to provide informative and useful feedback.
  • Performs other highly skilled functions as assigned by management.

CMS Coordinator

Optum
07.2014 - 01.2015
  • Responsible for all aspects of assigned MSA cases for submission to the Centers for Medicare/Medicaid Services.
  • Basic Functions:
  • Maintains and completes diary on cases submitted to CMS and other files with legal/technical issues. Manages Client Profiles/Allegro screens as necessary (case specifics, CMS Tab, Initial CMS Approval, CMS Discrepancy and client resolution)
  • Processes all mail related to cases submitted to CMS including requests for additional information (30 & 14 day letters).
  • Processes all mail (CMS Approvals) related to cases where CMS has approved a counter high or counter low allocation. Completes review of the file to identify major discrepancy points.
  • Prepares correspondence to client documenting CMS approved MSA amount.
  • Reviews and prepares portions of the CMS submission.
  • Reviews settlement documents and other pertinent file materials for proper submission to CMS.
  • Makes recommendations to our clients regarding resolution of any issues on the case prior to submission to CMS.
  • Handles phone calls from CMS regarding submitted cases.
  • Handles phone calls from clients regarding CMS submissions, questions, concerns and strategies.
  • Handles e-mails, Client Profiles/Allegro messages and faxes on assigned cases within 24 hours.
  • Completes diary follow up for CMS High Exposure Specialist as needed.
  • Completes special projects as required by Management.
  • Performs other duties as assigned by management.

Lien Specialist – Team Lead

PMSI Settlement Solutions (formerly Health Advocates)
03.2011 - 07.2014
  • Analyzes all conditional payments that are requested from clients, and provides them with detailed recommendations on how PMSI can dispute/appeal with MSPRC on their behalf.
  • Researches and determines ICD 9 codes to include in our disputes/appeals to MSPRC. Creates New Case Log for conditional payment verification specialists and adds ICD9 Codes. Sends to MSPRC bi-weekly and redistributes to team once the responses are received.
  • Handles all correspondence and escalation between conditional payment verification specialists and MSPRC.
  • Works with the SSV specialist and handles overflow where necessary. Acts as a back up in times of PTO or absences.
  • Works with conditional payment verification specialists and handles overflow where necessary. Acts as a back up in times of PTO or absences.
  • Reviews and revamps current workflows so better results can be achieved.
  • Participates in training programs as needed.
  • Works with Management on special projects as necessary.
  • Performs other job functions as assigned by management.

DVR Coordinator

PMSI Settlement Solution (formerly Health Advocates)
01.2009 - 03.2011
  • Reviewed cases to make sure specialist chose the correct medications and strengths Updated the DVR when needed to be thru access
  • Researched medications and compounds

Audits and Approval Coordinator

PMSI MSA (formerly Health Advocates)
04.2002 - 01.2009
  • Prepare Submission packets for files to be sent to Center for Coordination of Benefits
  • Request releases and/or missing information needed for CMS submission Follow-up on pending files that are missing information
  • Handle Daily Diaries
  • Assist clients via phone, email and/or fax
  • Update information in Client Profiles
  • Participate in cross-training within department
  • Communicate with client when MSA needs revision
  • Obtain current medical records if revision of MSA necessary
  • Assign CMS submission files to the submitters
  • Coordination of all incoming and outgoing communications
  • Assist four Audits and Approval Submitters

Lien Resolution Specialist and Marketing

Health Advocates
01.2005 - 01.2006
  • Kept contact with Coordination of Benefits (COB) to begin the Medicare lien process
  • Responsibilities included following up with changes related to claims, disputing of unrelated charges, and requested final demands
  • Kept contact with the clients to update/ request information
  • Marketing - Prepared marketing packets for representatives and kept files up to date

MSA Assistant

Health Advocates
01.2003 - 01.2005
  • Requested releases and/or missing information needed for MSA Followed-up on pending files
  • Handled daily diary
  • Assisted clients via phone, email and/or fax
  • Kept client profiles up to date
  • Participated in cross-training within department
  • Coordination of all incoming and outgoing communications
  • Responsible for rated age revisions
  • Responsible for Social Security verifications
  • Prepared all files for the MSA allocators
  • Sent all reports to the clients

Administrative Assistant

Health Advocates
01.2002 - 01.2003
  • Answer all incoming phone calls
  • Set up all new files in Client Profiles
  • Sort all incoming mail for the company

Certified Pharmacy Technician I-II

Walgreens Pharmacy
04.2000 - 04.2002
  • Job duties included, entering and filling of patient prescriptions, working with patients to get their medications, maintaining good communication between the patient and Pharmacy, inventory control of all medications, and working with insurance companies to get patients medications processed.

Education

High School Diploma -

Riverhills Christian School

Skills

  • Problem-solving skills
  • Inventory control
  • Order verification
  • Pharmaceutical calculations
  • Prescription processing
  • HIPAA
  • Insurance billing
  • Manual and automated medication dispensing
  • Resolving complaints
  • Customer service

Certification

  • CPhT - Certified Pharmacy Technician
  • Pharmacy-Based Immunization Delivery Certificate
  • Adult Child and Baby First Aid/CPR/AED
  • Registered Pharmacy Technician

Timeline

Lead Pharmacy Technician

CVS Pharmacy
10.2023 - Current

Recovery Specialist

Sanderson Firm
05.2022 - 03.2023

Clinical Coordinator and QC

Optum (formerly Health Advocates)(formerly PMSI Settlement Solutions)
02.2015 - 05.2022

CMS Coordinator

Optum
07.2014 - 01.2015

Lien Specialist – Team Lead

PMSI Settlement Solutions (formerly Health Advocates)
03.2011 - 07.2014

DVR Coordinator

PMSI Settlement Solution (formerly Health Advocates)
01.2009 - 03.2011

Lien Resolution Specialist and Marketing

Health Advocates
01.2005 - 01.2006

MSA Assistant

Health Advocates
01.2003 - 01.2005

Audits and Approval Coordinator

PMSI MSA (formerly Health Advocates)
04.2002 - 01.2009

Administrative Assistant

Health Advocates
01.2002 - 01.2003

Certified Pharmacy Technician I-II

Walgreens Pharmacy
04.2000 - 04.2002

High School Diploma -

Riverhills Christian School

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