Angela Cavazos
Georgetown
Summary
Dynamic Prior Authorization Specialist and Pharmacy Technician with a proven track record at Gainwell Technologies and HEB Pharmacy. Excelled in reducing authorization turnaround times and minimizing medication errors through expert application of medical terminology and data entry skills. Demonstrated exceptional professionalism and analytical thinking, ensuring compliance with HIPAA and enhancing workflow efficiency.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Gainwell Technologies
08.2022 - Current
- Input all patient data regarding claims and prior authorizations into system accurately.
- Supported team members by providing guidance on complex cases requiring detailed understanding of medical necessity criteria.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
Pharmacy Technician
HEB Pharmacy
03.2019 - 08.2022
- Counted and labeled prescriptions with correct item and quantity.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
- Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
- Reduced medication errors by diligently cross-checking medications against patients'' profiles before dispensing.
- Resolved third-party billing, computer system and customer service issues.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
Education
Georgetown High School
Georgetown, TX06.2016
Skills
- Prior authorization process
- Medical terminology
- Insurance verification
- Data entry
- Benefit coverage
- Professionalism and ethics
- Process improvement strategies
- Workflow management
- Claim research
- Proficiency in software
- Quality assurance practices
- HIPAA compliance
- Attention to detail
- Analytical thinking
Certification
- PTCB Certification - Certification # 30128572
- Texas State Board of Pharmacy Technician Certification - Certification # 249284
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Prior Authorization Specialist
Gainwell Technologies
08.2022 - Current
Pharmacy Technician
HEB Pharmacy
03.2019 - 08.2022
Georgetown High School