Andres Mendez
Altamonte Springs,FL
Summary
Experienced Pharmacy Technician with over 11 years in retail (Publix, CVS) and call center operations (Petmeds, Aetna). Skilled in prescription processing, patient coordination, insurance processing, and Medicare/Medicaid benefits. Promoted to Senior Pharmacy Resolution Specialist at Centene/Wellcare. Passionate about optimizing pharmacy operations and enhancing patient care.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Senior Pharmacy Resolution Specialist
Centene
05.2023 - Current
- Handles member, prescriber, and pharmacist inquiry calls, addressing benefit questions and prior authorization requests by offering options, including submission of prior authorization requests.
- Conducts thorough research on issues and takes appropriate action to resolve them within established turnaround time requirements and quality standards, utilizing appropriate reference material.
- Answers inbound and conducts outbound calls with members and provider offices to provide resolution to claims, including requests for additional information and medication determination updates.
- Guides team members to appropriate resolution of complex inquiries, participating in training of less experienced staff through job shadowing opportunities.
- Acts as liaison between internal departments for data gathering and problem-solving, presenting proposed solutions clearly and concisely.
- Assists with audit preparation and contributes to miscellaneous special project work as assigned.
Pharmacy Technician Quality Analyst
Aetna, A Cvs Company
11.2016 - 03.2023
- Manage inbound calls from healthcare providers to initiate prior authorizations, ensuring timely processing.
- Transcribe electronic faxes containing medication information to authorize claims accurately and efficiently.
- Review audit reports for Medicare Part D and B prior authorizations, identifying and rectifying errors to uphold compliance standards.
- Evaluate global and control reports to ensure precision and reliability in data analysis.
- Serve as Subject Matter Expert (SME) in new hire training sessions, imparting expertise and supporting skill development.
- Conduct outbound calls to patients to provide updates on pending cases, maintaining excellent customer service standards.
- Liaise with doctors' offices through outbound calls to obtain additional information necessary for completing reviews within compliance deadlines.
- Recognized for outstanding performance and promoted to Quality Analyst in December 2022.
Pharmacy Technician
Publix
01.2021 - 03.2022
- Prepared new prescription and refill requests for patients with meticulous attention to detail and accuracy.
- Dispensed medication to patients in accordance with the prescription or provider's orders, ensuring compliance with safety protocols.
- Expertly packed and labeled prescribed medication, adhering to pharmacy standards and regulations.
- Processed insurance claims efficiently and accurately, facilitating seamless transactions for patients.
- Maintained meticulous tracking of inventory to ensure adequate stock levels and timely replenishment.
Pharmacy Technician
1-800-PetMeds
02.2014 - 08.2016
- Liaised with veterinarian offices, clinics, and customers to facilitate the authorization of prescription medication orders.
- Utilized both manual and electronic methods to efficiently fax required information and requests.
- Transcribed hard copy prescriptions into the computer system to ensure accurate record-keeping and organizational efficiency.
- Managed a high volume of inbound calls from customers and veterinarian clinics, providing timely assistance and support.
- Successfully retained existing customers and acquired new ones on a daily basis through proactive and engaging interactions.
Pharmacy Technician
CVS Pharmacy
04.2013 - 01.2014
- Improved patient satisfaction by efficiently processing prescriptions and managing inventory in a timely manner.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
- Streamlined prescription processing with accurate data entry and verification of patient information.
- Greeted each customer promptly and directed them to the appropriate associate to address their needs efficiently.
- Efficiently read, interpreted, and accurately entered prescriptions into the computer system.
- Assumed responsibility for routing questionable prescriptions to the pharmacist for final completion, ensuring adherence to safety protocols.
- Conducted outbound calls and faxed physicians to clarify prescriptions, handle substitutions, and address formulary changes.
- Managed and updated insurance and discounted card information as required, ensuring seamless processing of transactions.
- Maintained meticulous organization of completed prescriptions and patient profiles, facilitating efficient retrieval and reference.
Education
High School Diploma -
Boca Raton High School
Boca Raton, FLBachelor of Science in Health Administration -
Florida Atlantic University
Skills
- De-Escalation Techniques
- Assertiveness
- Interviewing abilities
- Goal Setting
- Organizational Skills
- Medication techniques
- Excellent Communication
- Problem-solving aptitude
- Adaptability and Flexibility
- Decision-Making
Relevant Skill Set
- State Registered Pharmacy Technician with 3+ years of experience in a call center and retail environment
- Bilingual in English and Spanish, including medical terminology
- Proficient in Microsoft Office
Certification
- Registered Pharmacy Technician, State of FL – RPT51087 (Expires 12/31/25)
Languages
Spanish
Native or Bilingual
Timeline
Senior Pharmacy Resolution Specialist
Centene
05.2023 - Current
Pharmacy Technician
Publix
01.2021 - 03.2022
Pharmacy Technician Quality Analyst
Aetna, A Cvs Company
11.2016 - 03.2023
Pharmacy Technician
1-800-PetMeds
02.2014 - 08.2016
Pharmacy Technician
CVS Pharmacy
04.2013 - 01.2014
High School Diploma -
Boca Raton High School
Bachelor of Science in Health Administration -
Florida Atlantic University