Brenda Dean
Phoenix,AZ
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Certified Pharmacy Technician
Ascension Specialty Pharmacy
04.2022 - Current
- Prior authorization assistance
- Ensure compliance with regulatory requirements
- Process data entry and new patient registration
- Trouble-shoot and resolve all data entry released exceptions
- Ensures secure, accurate and up to date patient information in company software
- Receives and processes prescription refill requests
- Prepares and processes billing claims based on dispensing correct days' supply for prescriptions, and number of refills authorized, and quantity dispensed does not exceed state or federal limits that apply to controlled substance prescriptions
- Handles patient prescription requests within HIPAA guidelines and enters refill orders for processing
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Communicated directly with doctors offices via telephone, fax and email.
- Coordinated verification and filling of more than 60 daily prescriptions in high-volume pharmacy environment
Certified Pharmacy Technician Trainee
Walgreens Pharmacy
01.2021 - 05.2022
- Accurately prepare and distribute patient's medication
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles. (Commercial, Medicare, Medicaid, Tricare, Workers Comp.)
- Ensure compliance with regulatory requirements
- Prepare documents for any type of vaccines for Pharmacist
- Maintained proper drug storage procedures, registries, and records for controlled drugs.
- Trouble-shoot and resolve all data entry released exceptions
- Trouble shoot coordination of benefits
- Process data entry and new patient registration
- Prior authorization assistance
- Work directly with patients to obtain medication histories and reconciliation
- Maintained drug inventory levels by ordering necessary medications and supplies.
- Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.
- Worked with computerized and automated systems for dispensing medications and editing new patient profiles.
- Counted, measured and compounded medications following standard procedures.
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
- Coordinated verification and filling of more than 100 daily prescriptions in high-volume retail pharmacy environment
Case Manager
CoverMyMeds
10.2017 - 04.2022
- Provided exceptional support via phone, email, and web-based chat email, to insurance plans, patients, and prescribers.
- Worked through backend queues to support seamless ePA experience for users
- Worked through variety of time-sensitive and detail-oriented projects daily to help patients.
- Worked through variety of time-sensitive and detail-oriented projects daily to help patients.
- Managed existing user accounts, analyze usage, and collect feedback to improve/enhance service.
- Improved workflows by using critical thinking skills to track activity and identify areas for improvement.
- Troubleshooted issues and communicate insights through cross-collaboration with other teams within the company.
- Offered exceptional Prior Authorization knowledge via phone to patients and prescribers.
- Stayed up to date on changing procedures and workflows.
- Multi-tasked while being accurate and precise
- Built and develop skills like communication, attention-to-detail, critical thinking, and teamwork.
- Became expert on prior authorization process and a CoverMyMeds product expert.
- Coordinated webinars and provide expert knowledge on how to use the software.
- Became subject matter experts in one of many focused areas to offer specialized support to peers and users.
Customer service
AHCCCS, Long Term Care
05.2017 - 10.2017
- Processed documents and materials to disseminate information to appropriate parties.
- Maintained filing system and organized customer documents for easy retrieval of information.
- Processed incoming and outgoing mail and packages according to established procedures.
- Handled personal accounts
- Submitted and processed Long term care applications
- Verified all Medical claims had correct ICD-10 and J-codes before submitting application for approval
- Verified what type of Medicare the patient had to be able to select right forms
- Provided quality clerical support through data entry, document management, email correspondence, and overseeing operation of office equipment.
Grievance Analyst
CVS Specialty
08.2016 - 04.2017
- Customer service
- Relayed insurance benefits
- Bilingual calls
- Worked with mostly Medicare Part D benefits, for Caremark Silver Scripts
- Followed CMS and Silver scripts Guidelines
- Identified and resolved problems through root cause analysis and research.
- Generating grievance letter for patients to advise of outcome
- Assisted with patients receiving their medication when Prior Authorization or Appeal was pending (Transition fill)
- Processed pharmacy claims
- Generated refunds on paid claims that were made out of pocket
- Submitted Prior authorizations, Tier exceptions, Quantity Limit exceptions, Appeals, Re-determinations
- Made outbound calls to Pharmacy to ensure the prescription was billed correctly and verified the prescription to allow patients to receive medication in timely manner.
- Worked effectively in fast-paced environments.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Manager
Jamba Juice
03.2011 - 03.2016
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maintained professional, organized, and safe environment for employees and patrons.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Cross-trained existing employees to maximize team agility
- Coached team members in techniques necessary to complete job tasks.
- Built strong relationships with customers through positive attitude and attentive response.
Tech Support/Manager
Apple online Store
09.2014 - 11.2015
- Analyzed and developed service goals for in-bound call center.
- Tracked KPIs and created continuous improvement plans.
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Cross-trained existing employees to maximize team agility and performance.
- Onboarded new employees with training and new hire documentation.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
Education
High School Diploma -
Vicki. A. Romero
Phoenix, AZ05.2010
Skills
- Technician Assistance
- Prescriptions Management
- Insurance Claim Processing Software
- Insurance Billing
- Insurance Verification
- Spanish translation
Certification
- CPhT - Certified Pharmacy Technician
Languages
Spanish
Native or Bilingual
Timeline
Certified Pharmacy Technician
Ascension Specialty Pharmacy
04.2022 - Current
Certified Pharmacy Technician Trainee
Walgreens Pharmacy
01.2021 - 05.2022
Case Manager
CoverMyMeds
10.2017 - 04.2022
Customer service
AHCCCS, Long Term Care
05.2017 - 10.2017
Grievance Analyst
CVS Specialty
08.2016 - 04.2017
Tech Support/Manager
Apple online Store
09.2014 - 11.2015
Manager
Jamba Juice
03.2011 - 03.2016
High School Diploma -
Vicki. A. Romero
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