Anastasia Burroughs
Richmond,VA
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for pharmacy medications and in office medication injections. Detail-oriented performer with almost 10 years of pharmacy experience.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Reimbursement Specialist CPhT II
VCU Health Systems
2022.09 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for pharmacy medications and in office medication injections.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
Certified Pharmacy Technician II
VCU Health Systems
2019.05 - 2022.08
- Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
- Counted, measured and compounded medications following standard procedures.
- Resolved non-routine issues like third-party billing, computer system, and customer service issues.
- Assisted customers with over-the-counter product selection, providing knowledgeable recommendations.
- Coordinated communication between healthcare professionals to ensure seamless patient care transitions between providers or facilities.
Certified Pharmacy Technician I
VCU Health Systems
2018.05 - 2019.04
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
- Maintained accurate inventory levels for efficient pharmacy operations and cost control.
- Worked with computerized and automated systems for dispensing medications and editing new patient profiles.
Senior Certified Pharmacy Technician
Walgreens
2016.09 - 2018.04
- Resolve dosage conflicts, potentially harmful drug interactions, insurance issues and other matters to ensure patient safety/wellness
- Improved patient satisfaction scores by delivering exceptional customer service in a fast-paced, high-volume pharmacy setting.
- Ensured compliance with federal and state regulations by maintaining meticulous documentation of controlled substances and adhering to strict safety protocols.
- Knowledgeable with simple compounding prescriptions
- Assists pharmacists in scheduling and maintaining work flow
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Collected co-payments or full payments from customers.
- Conducted regular inventory audits to identify discrepancies and reduce instances of stockouts or expired medications on pharmacy shelves.
- Maintained a clean, organized work environment to uphold quality standards and minimize risk of contamination or error during medication preparation.
- Supported the development of junior pharmacy technicians through continuous training, mentorship, and performance evaluations.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
Pharmacy Technician
Walgreens
2015.05 - 2018.04
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
- Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
- Counted and labeled prescriptions with correct item and quantity.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Resolved dosage conflicts, potentially harmful drug interactions, insurance issues and other matters to ensure patient safety/wellness.
- Knowledgeable with simple compounding prescriptions.
Pharmacy Cashier
Westbury Pharmacy
2014.05 - 2015.04
- Registers customer purchases and prescriptions, collects cash and distributes change as requested; processes voids, returns, rain checks, refunds, and exchanges as needed.
- Supported pharmacy team by answering phone calls, directing inquiries, and taking accurate messages.
- Served as a reliable backup when staffing shortages occurred in other areas of the pharmacy or store.
- Efficiently processed prescription drop-offs and pick-ups while maintaining strict adherence to HIPAA regulations.
- Made pharmacy insurance calls for any issues or rejection claims.
Education
Associate of Applied Science -
John Tyler Community College
Midlothian, VAHigh School Diploma -
James River High School
Midlothian, VA06.2013
Skills
- Prior Authorization Process
- ICD-10 Coding Familiarity
- Medical Terminology
- Medicare and Medicaid knowledge
- Data Entry
- HIPAA Compliance Knowledge
- Pharmacy benefit management
- Insurance Verification
- Effective communication skills
Certification
- Certified Pharmacy Technician (CPhT)
- Virginia Pharmacy Technician Certification
Training
Bremo Pharmacy Technician Preparatory
Timeline
Reimbursement Specialist CPhT II
VCU Health Systems
2022.09 - Current
Certified Pharmacy Technician II
VCU Health Systems
2019.05 - 2022.08
Certified Pharmacy Technician I
VCU Health Systems
2018.05 - 2019.04
Senior Certified Pharmacy Technician
Walgreens
2016.09 - 2018.04
Pharmacy Technician
Walgreens
2015.05 - 2018.04
Pharmacy Cashier
Westbury Pharmacy
2014.05 - 2015.04
Associate of Applied Science -
John Tyler Community College
High School Diploma -
James River High School
- Certified Pharmacy Technician (CPhT)
- Virginia Pharmacy Technician Certification
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