Cecilia Cisneros
Skokie,IL
Summary
Certified Pharmacy Technician with 18 years of experience in long-term care (LTC) pharmacy. Skilled in workflow optimization, medication management, staff leadership, and insurance adjudication. Proven ability to coordinate cross-functional operations to ensure accuracy, compliance, and exceptional service.
Overview
2027
2027
years of professional experience
Work History
Pharmacy Manager
CareOne Pharmacy
Skokie, IL
01.2019 - Current
- Lead and supervise pharmacy technicians, ensuring efficient and accurate medication dispensing.
- Manage daily pharmacy operations, including box exchange programs (EDK, Emergency, Refrigerated, IV Antibiotic, IV Fluid).
- Develop and implement standardized workflows for medication tracking, box replenishment, and billing coordination.
- Collaborate with IT, billing, and compliance departments to streamline reporting and ensure adherence to LTC regulations.
- Coordinate with facilities, drivers, and pharmacists to maintain efficient medication flow and prompt deliveries.
- Conduct technician training, performance evaluations, and scheduling to maximize team productivity.
- Support continuous improvement initiatives to enhance accuracy, compliance, and turnaround times.
- Managed pharmacy operations, ensuring compliance with regulatory standards and company policies.
- Trained and mentored pharmacy staff on best practices for medication dispensing and patient care.
- Implemented workflow improvements, enhancing efficiency in prescription processing and delivery times.
- Analyzed operational data to identify trends and implement strategic changes for better performance outcomes.
- Monitored and managed pharmacy staff performance to maximize productivity and customer satisfaction.
- Led a high-performing team of pharmacists and technicians to deliver exceptional patient care and service.
- Trained pharmacy interns and newly hired pharmacy technicians.
Adjudication Specialist
MAC Rx
Skokie, IL
01.2017 - 01.2019
- Processed prescription claims through third-party insurance systems to ensure timely adjudication.
- Reviewed, verified, and resolved rejected claims by analyzing payer responses and adjusting billing as needed.
- Collaborated with pharmacists, prescribers, and insurance carriers to resolve discrepancies.
- Monitored daily claim queues and ensured timely completion of all outstanding issues.
- Assisted billing teams with complex claim reviews and coordination of benefits.
- Maintained compliance with state and federal pharmacy billing standards.
- Assessed patient needs and provided tailored pharmaceutical recommendations.
Prior Authorization Specialist
Pharmore Drugs LLC
Skokie, IL
2010 - 01.2017
- Ensured patients received medications requiring pre-authorizations from insurance carriers.
- Assisted with medical necessity documentation and expedited approvals for continuity of care.
- Developed and implemented workflows, policies, and procedures for the prior authorization department.
- Managed communication with insurance companies, physicians, specialists, and patients.
- Reviewed denials, prepared appeals, and collaborated with billing to resolve issues.
- Supported pharmacy staff in addressing insurance and authorization inquiries.
- Processed prior authorization requests efficiently, ensuring compliance with regulatory standards.
- Communicated effectively with healthcare providers to clarify information and expedite approvals.
- Reviewed patient medical histories to determine eligibility for prescribed medications.
- Collaborated with pharmacy team to resolve issues related to denied authorizations.
- Trained new staff on best practices for managing prior authorization workflows.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
Fill Technician
Pharmore Drugs LLC
Skokie, IL
2008 - 2010
- Filled prescriptions in compliance with State Board of Pharmacy guidelines.
- Entered patient and medication data into the computer system accurately.
- Packaged, labeled, and prepared medications for dispensing and delivery.
- Conducted inventory management, receiving, and restocking processes.
- Performed facility cart audits and ensured medication accuracy.
- Trained new staff on standard operating procedures and safety practices.
- Collaborated with pharmacists to review prescription orders and ensure accuracy in medication dispensing.
Medical Assistant
Access Hawthorne Family Center
Cicero, IL
01.2005 - 01.2008
- Handled patient registration, scheduling, insurance verification, and payment processing.
- Maintained charts, filed documentation, and submitted prior authorizations.
- Administered vaccinations, recorded vital signs, and assisted with minor surgical procedures.
- Conducted lab tests, including HCG and specimen collection.
- Assisted with patient intake procedures and collected medical histories.
- Coordinated appointment scheduling to optimize clinic workflow.
- Managed inventory of medical supplies and ensured compliance with safety protocols.
- Conducted routine laboratory tests and processed specimens efficiently.
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Performed medical records management, including filing, organizing and scanning documents.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Performed phlebotomy tasks efficiently while ensuring minimal discomfort for patients during blood collection procedures.
- Boosted patient satisfaction by providing compassionate care and promptly addressing needs during visits.
Education
Associate of Science - Respiratory Therapist Program
St. Augustine College
Chicago, IL01-2016
Medical Assistant / Phlebotomy Certificate
Everest College
Chicago, IL01-2005
High School Diploma - undefined
Steinmetz High School
Chicago, IL01-2002
Skills
- Exceptional verbal, written, and computer skills (Microsoft Word, Excel, Access, PowerPoint, Internet, billing software)
- Pharmacy systems: Framework, DocuTrack, Helix
- Strong understanding of pharmacy operations, LTC workflow, and compliance
- Medical terminology, vital signs, laboratory procedures
- ICD-9, CPT coding, and insurance verification
- Certified Illinois Pharmacy Technician License
- Fluent in English and Spanish
- Documentation practices
- Effective problem solving
- Efficient time management
- Teamwork and collaboration
- Adaptability
- Workflow management
- Record keeping
- Goal setting
- Time management
- Attention to detail
- Teamwork
- Decision-making
- Multitasking
- Critical thinking
- Excellent communication
- Adaptability and flexibility
Timeline
Pharmacy Manager
CareOne Pharmacy
01.2019 - Current
Adjudication Specialist
MAC Rx
01.2017 - 01.2019
Medical Assistant
Access Hawthorne Family Center
01.2005 - 01.2008
Medical Assistant / Phlebotomy Certificate
Everest College
High School Diploma - undefined
Steinmetz High School
Prior Authorization Specialist
Pharmore Drugs LLC
2010 - 01.2017
Fill Technician
Pharmore Drugs LLC
2008 - 2010
Associate of Science - Respiratory Therapist Program
St. Augustine College