Anusha Ramanadham
Woodstock
Summary
Detail-oriented Pharmacy Technician with a B.S. in Pharmaceutical Sciences and diverse experience across clinical, retail, and PBM settings. Expertise in processing prior authorizations, resolving prescription and claims issues, and ensuring regulatory compliance while managing multiple work queues. Committed to enhancing medication access and operational precision.
Overview
17
17
years of professional experience
Work History
Pharmacy Technician
Prime Therapeutics LLC
Minneapolis
01.2025 - Current
- Processed and reviewed prior authorization, formulary exception, quantity limit exception, and brand override requests in accordance with client and regulatory guidelines.
- Evaluated requests against clinical criteria and accurately entered approvals into pharmacy claims systems.
- Communicated authorization determinations to providers, pharmacies, and members within required turnaround times.
- Researched and resolved prior authorization inquiries, documentation issues, and claim-related concerns.
- Collaborated with pharmacists and physicians by providing relevant clinical information for complex cases requiring clinical review.
- Managed multiple work queues while maintaining productivity, accuracy, and service-level agreements (SLAs).
- Conducted outreach to physician offices and pharmacies to obtain additional information needed for authorization reviews.
- Utilized pharmacy benefit management (PBM) systems and maintained detailed documentation of authorization outcomes.
- Received written prescription or refill requests, verifying information for completeness.
- Communicated effectively with doctors and insurance agencies to resolve prescription cost discrepancies.
- Entered patient and prescription information into pharmacy software systems with high attention to detail.
- Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
- Compiled reports summarizing daily activities related to processing of prior authorizations.
- Analyzed prior authorization request forms to determine appropriate coding before submission.
- Received written prescriptions and refill requests from patients, evaluating information for completeness and accuracy before filling.
- Conducted outbound outreach to prescribers' offices, pharmacies, and health plan members to obtain clinical information, facilitate prior authorization approvals, and ensure timely medication access.
- Collaborated with prescribers, pharmacy staff, and members via phone and electronic communication while working in a remote environment.
- Followed up on pending prior authorization requests to ensure accurate documentation and timely resolution.
- Completed day-to-day duties accurately and efficiently.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Identified needs of customers promptly and efficiently.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Collaborated closely with team members to achieve project objectives and meet deadlines.
- Assisted with customer requests and answered questions to improve satisfaction.
- Worked with cross-functional teams to achieve goals.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
- Recognized by management for providing exceptional customer service.
- Utilized advanced technical skills and expertise to troubleshoot complex problems and implement solutions.
- Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
- Utilized various software and tools to streamline processes and optimize performance.
- Achieved cost-savings by developing functional solutions to problems.
- Operated a variety of machinery and tools safely and efficiently.
- Exceeded customer satisfaction by finding creative solutions to problems.
- Maintained updated knowledge through continuing education and advanced training.
- Approached customers and engaged in conversation through use of effective interpersonal and people skills.
- Conducted routine maintenance and repairs on mechanical systems and industrial equipment.
- Managed healthcare administrative data, including pharmacy claims, prescription drug utilization records, insurance benefit information, and prior authorization documentation to support medication access and healthcare operations.
- Reviewed and analyzed pharmacy claims, coverage criteria, formulary requirements, and payer guidelines to identify issues and facilitate timely resolution of medication access barriers.
- Maintained and validated large volumes of healthcare records, ensuring accuracy, completeness, consistency, and compliance with HIPAA and organizational quality standards.
- Performed data quality reviews, reconciliation, and documentation audits to identify discrepancies and improve accuracy of administrative healthcare datasets.
- Collected, organized, and analyzed prescription utilization data to support reporting, workflow improvements, and operational decision-making.
- Utilized pharmacy and healthcare information systems to document authorization outcomes, claims activity, provider communications, and patient case details.
- Collaborated with providers, pharmacies, payers, pharmacists, and internal teams to resolve claims-related issues and improve healthcare service delivery.
- Prepared reports, tracking summaries, and documentation related to prior authorization volume, turnaround times, approval outcomes, and operational metrics.
- Supported healthcare data management activities through data validation, record maintenance, quality assurance checks, and process improvement initiatives.
- Assisted with preparation of technical documentation, operational reports, and deliverables by compiling and summarizing healthcare data findings.
- Applied knowledge of pharmacy benefits, managed care processes, insurance policies, and medication coverage requirements to support efficient healthcare operations.
- Maintained confidentiality and security of sensitive patient information while managing complex healthcare datasets.
- Used SQL and analytical tools (SAS/Python/R, as applicable) to extract, organize, analyze, and report healthcare data for operational insights and quality improvement.
- Applied data management and validation techniques to identify trends, improve reporting accuracy, and support data-driven healthcare decisions.
Shift Supervisor
CDS
Atlanta
09.2024 - 01.2025
- Ensured all safety and sanitation regulations were met throughout the shift.
- Conducted weekly inventory of supplies, equipment, and food items.
- Assigned tasks to team members based on their strengths and skill sets.
- Monitored staff performance to ensure quality standards were met.
- Resolved any issues that may arise before or during an event.
- Ensured compliance with health and safety regulations at all times.
- Analyzed data collected from past events in order to identify areas of improvement.
- Supervised small group activities.
Event Specialist
Advantage Solutions
Atlanta
08.2024 - 08.2024
- Resolved any issues that may arise before or during an event.
- Ensured compliance with health and safety regulations at all times.
- Analyzed data collected from past events in order to identify areas of improvement.
- Supervised small group activities.
Assistant Teacher
Big Blue Marble Academy
Atlanta
08.2024 - 08.2024
- Collaborated with other staff members to develop strategies for improving student performance.
- Promoted a cooperative learning environment that encourages collaboration amongst students.
Pharmacist
Kadari Medicals
Kakinada
02.2015 - 05.2017
- Reviewed prescriptions for accuracy and completeness prior to dispensing.
- Managed the daily operations of a retail or hospital pharmacy.
- Analyzed physician's medication orders for correctness according to policy guidelines.
- Ordered, labeled, compounded and dispensed prescribed medications.
- Counseled health care professionals regarding therapeutic options, formulary restrictions, drug interactions and side effects.
- Organized inventory control systems to maintain adequate stock levels for all products carried by the pharmacy.
- Advised customers on non-prescription medications such as over-the-counter drugs, herbals and nutritional supplements.
- Verified accuracy of prescription labels before dispensing medications.
- Completed day-to-day duties accurately and efficiently.
- Understood and followed oral and written directions.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Sr Analytical Scientist
Mylan Laboratories
Hyderabad
03.2011 - 12.2013
- Trained junior analysts on proper use of equipment and techniques employed in the lab environment.
- Interpreted experimental data and communicated results effectively to management team.
- Evaluated the results of experiments by analyzing data with appropriate statistical tools.
- Developed test plans for validation studies of new analytical methods or existing method modifications.
- Analyzed data from process control systems to identify trends or areas for further investigation.
- Conducted quality audits on incoming and outgoing products to ensure compliance with standards.
- Managed inventory levels of raw materials, components, and finished goods, ensuring accuracy at all times.
- Maintained accurate records of all inspection results, findings, and corrective actions taken.
QC Officer
Medreich Ltd
Bengaluru
07.2009 - 02.2011
- Collaborated with other staff members to develop strategies for improving student performance.
- Promoted a cooperative learning environment that encourages collaboration amongst students.
- Reviewed prescriptions for accuracy and completeness prior to dispensing.
- Managed the daily operations of a retail or hospital pharmacy.
- Analyzed physician's medication orders for correctness according to policy guidelines.
- Ordered, labeled, compounded and dispensed prescribed medications.
- Counseled health care professionals regarding therapeutic options, formulary restrictions, drug interactions and side effects.
- Organized inventory control systems to maintain adequate stock levels for all products carried by the pharmacy.
- Advised customers on non-prescription medications such as over-the-counter drugs, herbals and nutritional supplements.
- Verified accuracy of prescription labels before dispensing medications.
- Completed day-to-day duties accurately and efficiently.
- Understood and followed oral and written directions.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Education
Bachelor Of Science - Pharmaceutical Sciences
GIET School Of Pharmacy
RajamahendravaramSkills
- Claims analysis
- Claims validation
- Prior Authorization Data Management
- Formulary analysis
- Patient Record Maintenance
- HIPAA compliance
- Healthcare information systems
- Insurance data concepts
- Data quality assurance
- Data cleaning
- Data extraction
- Dataset management
- Reporting and documentation
- Managed care knowledge
Timeline
Pharmacy Technician
Prime Therapeutics LLC
01.2025 - Current
Shift Supervisor
CDS
09.2024 - 01.2025
Event Specialist
Advantage Solutions
08.2024 - 08.2024
Assistant Teacher
Big Blue Marble Academy
08.2024 - 08.2024
Pharmacist
Kadari Medicals
02.2015 - 05.2017
Sr Analytical Scientist
Mylan Laboratories
03.2011 - 12.2013
QC Officer
Medreich Ltd
07.2009 - 02.2011
Bachelor Of Science - Pharmaceutical Sciences
GIET School Of Pharmacy