Bridget Phelix
Mesquite,Texas
Summary
Strong efficient professional with experience and knowledge of data collection, benefits analysis, and clinical services. Supervised a team of sixteen staff members. Highly organized and efficient, responsible for configuration of Client Pharmacy Benefits, Plan management and New Implementations .
Overview
18
18
years of professional experience
Work History
Client Benefits Supervisor
CVS Health
03.2022 - Current
- Managing day to day operations of configuration team
- Making hiring and firing decisions for configuration representatives
- Actively managing the performance of configuration representatives according to established Key performance Indicators
- Ensuring the team is adhering to the configuration standards and producing high quality, predictable outcomes
- Defining and rolling out new configuration standards to team based on market segment.
- Skilled at working independently and collaboratively in a team environment.
- Worked well in a team setting, providing support and guidance.
- Worked effectively in fast-paced environments.
- Managed time efficiently in order to complete all tasks within deadlines.
- Identified issues, analyzed information and provided solutions to problems.
- Participated in team projects, demonstrating an ability to work collaboratively and effectively.
- Cultivated interpersonal skills by building positive relationships with others.
Clinical Consultant
CVS Health
02.2017 - 01.2022
- Responsible for Coding/ QA maintenance of business & New Implementation case & ensuring client intent is met
- Responsible for moving/tracking daily work to ensure client commitment dates are met in a timely manner
- Train new employees on process and procedures
- Build team Standard Operating Procedure SOP.
Benefits Specialists
CVS Health
10.2013 - 02.2017
- Responsible for testing and verifying the quality of the client’s plan design additions and changes within the adjudication support system
- Communicates clearly and professionally with internal partners related to all aspects of the client’s intent
- Review analytical results to deliver high quality and avoid production issue.
Sr. Operations Specialists
PNC Bank
03.2011 - 10.2013
- Interprets and processes a variety of transactions in a production environment
- Adheres to production schedule to ensure completion of tasks by required deadlines
- Keying Explanation of Benefits (EOB’s) or verifying OCR data in the production system.
Emergency Dispatch Operator
Monitronics
05.2009 - 03.2011
- Reads, interprets and records as needed, signals received from customer’s premises
- Initiates necessary action when irregular signals are received, or trouble develops
- Notify appropriate authorities and customers if alarm signal is received
- Must be able to adhere to standard operating procedures and special instructions
- Document alarm activity and subscriber phone calls via PC and activity reports
- Contact customer via telephone to inquire about unusual events with the customer’s alarm system.
- Received incoming telephone and alarm system calls regarding emergency and non-emergency situations and dispatched appropriate police, fire and ambulatory services to premises.
- Assessed emergency requests and made quick judgment calls to determine appropriate action.
- Followed established protocols for professional handling of emergency situations.
- Routed calls to police, fire, and ambulance service to meet individual call needs.
Lead Sales Associate
Dillards
07.2007 - 07.2008
- Assisted Manager with training of new sale associates
- Greeted customers in a timely, professional, and courteous manner
- Assisted customers in check out, returns and refund transactions
- Performed merchandising such as stock and re-merchandising displays and price markdowns.
- Trained, coached, and mentored new sales associates for maximum performance.
- Answered customer questions about products and services, helped locate merchandise, and promoted key items.
- Processed and stocked merchandise in accordance with store standards.
- Maintained store visual standards by setting up window and interior displays to merchandising guidelines.
Customer Service / Pharmacy Technician Trainee
Albertsons
08.2005 - 07.2007
- Assisted customers with question, comments, and concerns via face-to-face and/or on-line
- Assisted customers with money gram transactions and check cashing
- Handled returns and refunds
- Provided excellent customer service to all patients and medical professionals via phone and in person
- Determined appropriateness of overriding pharmacy claims
- Determined insurance eligibility using computerized system
- Initiating and receiving refill authorization request
- Entered prescription data into data processing system
- Completed daily filing of prescriptions.
Education
Management-Supervisor -
Cedar Valley Community College
Dallas, TX01.2019
Medical Coding & Billing Specialists -
CCI Training Center
Dallas, TX01.2010
Skills
- Data Analysis
- Problem solving
- Pharmacy benefit design
- Team leadership
- Pharmacy network management
- Drug utilization review
- Attention to detail
- Claims processing
Qualification Highlights
- 10 years’ experience in Pharmacy Benefits Management
- Proficient in Microsoft excel, word, Salesforce & RX Claim/ AS 400
- 12 years’ experience in Quality Assurance
- Proficient in Running and Analyzing pharmacy claims
- Strong analytical and problem-solving abilities
References
REFERENCES AVAILABLE UPON REQUEST
Timeline
Client Benefits Supervisor
CVS Health
03.2022 - Current
Clinical Consultant
CVS Health
02.2017 - 01.2022
Benefits Specialists
CVS Health
10.2013 - 02.2017
Sr. Operations Specialists
PNC Bank
03.2011 - 10.2013
Emergency Dispatch Operator
Monitronics
05.2009 - 03.2011
Lead Sales Associate
Dillards
07.2007 - 07.2008
Customer Service / Pharmacy Technician Trainee
Albertsons
08.2005 - 07.2007
Management-Supervisor -
Cedar Valley Community College
Medical Coding & Billing Specialists -
CCI Training Center
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