ANDREA Anderson

• Self-motivated, with a strong sense of personal responsibility.
• Worked effectively in fast-paced environments.
• Skilled at working independently and collaboratively in a team environment.
• Proven ability to learn quickly and adapt to new situations.
• Preparing Prior Authorizations requests.
• Review and analyze pharmacy claims data for proactive outreach and intervention.
• Working the PA Tech Approval Queue, approving PAs.

• Receiving and entering prescriptions, patient enrollment, filling prescriptions, inventory management, ParataMax robot inventory management, insurance billing and adjudication specialist, close partnership with nurses for patient medication adherence and safety, providing culturally sensitive customer service, team meeting minutes. Mental health awareness and training. Trauma informed care.

Pulling MediSpan daily, tracking new drugs to market and any drug changes, batch loading formularies and status into RxClaim, maintaining the Utilization Master for all drugs, creating LMNs from PCPs, uploading LMNs and PCPs to SharePoint, uploading LMNs to CoverMyMeds, assist in the development of newsletters, client programs, drug pipeline reports, RxFlex implementation and maintenance, Relay journey building for PBM programs and USSC refill reminders (text program), disruption reports, AMR Responses, tracking and uploading, formulary status for pricing reports, Limited Distribution pharmacy access research and maintenance of lists, creating disruption for USSC to access new members, Prior Authorization support and updates, plan PA status tracking – contacting pharmacies to process claims (KPI Reports), Quality Control, organizing the P&T Committee Meeting - Meeting Minutes, slides – editing and formatting, calendar invites and communication with providers, check requests for providers, provider credentials, disclosures, confidentiality, contracts. Organizing all other clinical department meetings, rebates claims and summaries, tracking and maintaining of J-codes.

Receiving and entering prescriptions, patient enrollment, filling prescriptions, inventory management, ParataMax robot inventory management, insurance billing and adjudication specialist, close partnership with nurses for patient medication adherence and safety, providing culturally sensitive customer service, team meeting minutes. Mental health awareness and training.

Receiving and entering prescriptions, patient enrollments, tracking team errors and productivity and sending weekly email updates to the team and management, working with pharmacists to correct errors, team scheduling, limbo and stuck prescription monitoring and research, monitoring queues for proper function and coordinating with proper departments to resolve issues, PDMP reporting for all 5 pharmacies for every state and ensuring proper coding to upload files, failed claims, US Specialty Care Pharmacy outbound patient care calls.

Started in Target Pharmacy in 2008, became certified in 2009. Responsible for entering and filling prescriptions, ensuring proper insurance billing, guest service, phones, scheduling pharmacy technicians, daily ordering of inventory, inventory control, coordinating prior authorizations and refill requests.