Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Chanice Fairley

Raleigh,NC

Summary

Highly Motivated and detailed oriented professional with expertise in data analysis, project management, and process improvement. Adept at trouble shooting and resolving complex issues. Skilled in developing and implementing innovative strategies to reduce cost and increase efficiency.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Implementation Specialist

S&S Healthcare
08.2023 - Current
  • Implemented training initiatives by incorporating industry trends and collaborating with senior leaders.
  • Managed multiple implementation projects concurrently, maintaining strict deadlines without compromising quality or scope.
  • Helped streamline repair processes and update procedures for support action consistency.
  • Aided senior leadership in authoring data capturing reports to identify issues and determine solutions.
  • Focused solutions on industry-specific workflow, client base and protocols, tailoring implementations to client needs.
  • Delivered exceptionally high level of professionalism and support to each client, upholding company's commitment to service.
  • Conducted detailed requirements analysis for each project, creating customized solutions based on client needs.
  • Maintained up-to-date knowledge of industry trends and best practices in order to provide the most relevant solutions for clients'' businesses.
  • Enhanced customer satisfaction with timely resolution of issues during project implementations.
  • Documented specialized data and requirements to address business demands.
  • Developed strong relationships with clients, fostering trust and confidence in the implementation process.
  • Collaborated with vendors to locate replacement components and resolve advanced problems.
  • Provided ongoing support to clients post-implementation, addressing any concerns or issues promptly and professionally.
  • Developed clear documentation for all implementation processes and procedures, enabling easy knowledge transfer among team members.
  • Contributed to the continuous improvement of implementation processes through regular feedback sessions and lessons learned discussions.
  • Worked flexible hours across night, weekend, and holiday shifts.
  • Worked effectively in fast-paced environments.
  • Demonstrated a high level of initiative and creativity while tackling difficult tasks.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
  • Self-motivated, with a strong sense of personal responsibility.
  • Gained extensive knowledge in data entry, analysis and reporting.
  • Proved successful working within tight deadlines and a fast-paced environment.
  • Demonstrated leadership skills in managing projects from concept to completion.
  • Skilled at working independently and collaboratively in a team environment.
  • Excellent communication skills, both verbal and written.
  • Worked well in a team setting, providing support and guidance.
  • Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
  • Provided professional services and support in a dynamic work environment.

Clinical Care Navigator/Insurance Specialist

Biologics By McKesson
03.2022 - 08.2023
  • Promoted a culture of continuous learning and improvement within the navigation department by conducting regular training sessions on various topics related to safety and seamanship.
  • Maintained Detailed Records of all Insurance Transactions, including Payments, Renewals, cancellations.
  • Identified Opportunities for cost savings through the use of innovative solutions.
  • Ensured Timely processing of applications by coordinating resources across multiple departments.
  • Provided Guidance and support to team members regarding insurance regulations and requirements.
  • Monitored industry changes in order to stay up-to-date on regulatory requirements.
  • Prepared presentations for senior management outlining key findings from research projects.
  • Analyzed data to identify trends in claims and adjust policies accordingly.
  • Assisted in training new staff members on proper procedures related to insurance processes.
  • Reviewed claims and documents for accuracy prior to submission for payment processing.
  • Collaborated with other departments to develop strategies for expanding product offerings.
  • Responded promptly to customer inquiries regarding their insurance coverage options.
  • Researched and evaluated potential clients' financial information to determine eligibility for coverage and assistance.
  • Enter new patient and provider information accurately into the pharmacy MIS.
  • Review contents of Referrals to ensure complete and accurate information has been received and entered into the pharmacy system.
  • Adjudicate claims and troubleshoot rejections
  • Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the prior authorization process.
  • Submit and prepare prior authorizations for review and approval.
  • Manage inbound calls from patients, clients, physicians, practitioners, and clinics regarding inquires about order status, services provided, and financial support options (i.e. grants, manufacturer coupons/vouchers, free manufacturer bridge supply, and manufacturer patient assistance programs)
  • This is a high level "white glove service" client/account management position.

Patient Assistance Specialist

Biologics By McKesson
01.2020 - 03.2022
  • Interpreted clients' needs and introduced services to fit specific requirements.
  • Responded quickly to emergency situations involving critical or life-threatening events.
  • Assessed postoperative recovery status of patients after surgery or procedures.
  • Actively participated in team meetings to discuss best practices for patient care management.
  • Focused on patient and provider access toward oral oncolytics using best practices to overcome payor hurdles, including overrides, prior authorizations, network coordination, as well as, removing financial barriers through utilizing manufacturer and foundational assistance programs.
  • Submitting, preparing, and reviewing prior authorizations in support of medical practices, hospitals, and specialty medical facilities, and patients.
  • Assisting in the appeals process for denied medications and claims.

Patient Enrollment Specialist II

C3 HealthcareRX
02.2019 - 01.2020
  • Gathered, organized and input information into digital database.
  • Reviewed applications for accuracy before submitting to the appropriate entities for processing.
  • Manged telephonic inbound calls to assist patients with customer care inquires, while demonstrating personal and compassionate aptitudes to patients.
  • Telephonic outbound outreaches to develop and maintain excellent patient/member relationships after they are converted to C3 Pharmacies.
  • Maintaining proper documentation in multiple databases is an essential responsibility of this role.
  • Worked directly with insurance companies, files insurance claims, process refill authorizations as needed and managed patient's account balances and posting payments.


Patient Assistance/Prior Authorization Pharmacy Technician

Duke University Health System
03.2019 - 08.2019
  • Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
  • Verified eligibility for coverage of services through online portals and other resources, demonstrating proficient computer literacy skills.
  • Successfully resolved issues related to denied claims using critical thinking strategies while remaining compliant with all applicable laws and regulations.
  • Processed and submitted prior authorization requests for various insurance companies in a timely manner, demonstrating excellent organizational and multitasking skills.
  • Provided customer service to patients and providers via phone or email inquiries regarding the status of prior authorization requests, showcasing excellent interpersonal abilities.
  • Researched medical necessity criteria for specific services requested on prior authorizations utilizing effective communication with providers as needed.
  • Utilized electronic health record system (EPIC) to document pertinent information received from patient's or providers accurately, highlighting superb data entry expertise.
  • Coordinate drug delivery and continuity of care with Duke retail pharmacies.

Certified Pharmacy Technician

UNC Health Care System
08.2018 - 02.2019
  • Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
  • Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
  • Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
  • Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
  • Counseled customers on medications, appropriate dosage and potential side effects.
  • Identified areas for improvement in workflow processes and implemented changes that led to increased efficiency within the pharmacy.
  • Managed opening and closing duties for pharmacy.
  • Proactively addressed potential conflicts or discrepancies within the pharmacy team to maintain a positive work environment.
  • Contributed to improved patient adherence by providing clear medication instructions and addressing concerns or questions promptly.
  • Assisted in preparation, distribution and storage of pharmaceuticals.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Maintained proper drug storage procedures, registries, and records for controlled drugs.
  • Located and measured medications according to prescription information, making modifications as instructed by pharmacists and providers.
  • Assisted customers with over-the-counter product selection, providing knowledgeable recommendations.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Resolved third-party billing, computer system and customer service issues.
  • Maintained accurate inventory levels for efficient pharmacy operations and cost control.
  • Coordinated with physicians and insurance agency representatives for speedy resolution of prescription discrepancies.
  • Collected co-payments or full payments from customers.
  • Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.
  • Streamlined pharmacy operations through effective organization of supplies, workspace layout optimization, and process improvements.

Reimbursement Case Manager

Trial Card
06.2018 - 08.2018
  • Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
  • Implemented case management plans, provided assessments, and offered counseling and support.
  • Facilitated referrals to collaborative specialty health providers to drive continuity of care.
  • Demonstrated success in building relationships with clients and providing emotional support.
  • Supported various reimbursement functions including but not limited to benefits investigations, prior authorization support, and call triage.
  • Respond to all patient, nursing and provider account inquires.
  • Documents all provider, payor, and client interactions into various systems that are in compliance with HIPAA regulations.
  • This a high level "white glove service" client/account management position. Working directly with client/manufacturer.

Certified Pharmacy Technician

Caremark Specialty Pharmacy
09.2014 - 06.2018
  • Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
  • Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
  • Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
  • Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
  • Counseled customers on medications, appropriate dosage and potential side effects.
  • Identified areas for improvement in workflow processes and implemented changes that led to increased efficiency within the pharmacy.
  • Developed a systematic approach to organize medications, reducing errors and improving efficiency in the workflow.
  • Proactively addressed potential conflicts or discrepancies within the pharmacy team to maintain a positive work environment.
  • Contributed to improved patient adherence by providing clear medication instructions and addressing concerns or questions promptly.
  • Maintained proper drug storage procedures, registries, and records for controlled drugs.
  • Located and measured medications according to prescription information, making modifications as instructed by pharmacists and providers.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Reduced medication waste by implementing proper disposal procedures compliant with environmental guidelines.
  • Counted, measured and compounded medications following standard procedures.
  • Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
  • Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
  • Liaised with other pharmacies to eliminate issues related to product expiration.
  • Precisely measured and combined ingredients to deliver scrupulous formulation on customer compound prescription orders.
  • Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.

Pharmaceutical Research Pharmacy Technician

PPD/Kelly Services
08.2013 - 09.2014
  • Verified dosages and measured medications for prescriptions.
  • Maintained patient confidentiality when handling records and sensitive data.
  • Followed standard operating procedures for maintaining accurate and readily retrievable accountability records.
  • Answering multiple phone lines in a professional call center environment.
  • Prescription Drug/Pharmacy Research.
  • Outbound calling regarding side effects and overall patient health.
  • Spreadsheet development and organization.
  • This is a high level "white glove service" client/account management position for a then, FDA newly approved medication, working directly with manufacturer.

Certified Pharmacy Technician

Target Pharmacy
07.2010 - 05.2012
  • Entered and processed patients' prescriptions into internal system.
  • Identified areas for improvement in workflow processes and implemented changes that led to increased efficiency within the pharmacy.
  • Contributed to improved patient adherence by providing clear medication instructions and addressing concerns or questions promptly.
  • Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
  • Streamlined pharmacy operations through effective organization of supplies, workspace layout optimization, and process improvements.
  • Provided consultations and answered inquiries from patients, healthcare professionals and physicians regarding drugs, potential side effects, and specified use.
  • Assisted in preparation, distribution and storage of pharmaceuticals.
  • Ensured medication safety with thorough verification of prescription orders and drug interactions.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Collaborated with pharmacists to resolve medication-related issues, optimizing patient outcomes.
  • Collected co-payments or full payments from customers.
  • Welcomed customers to pharmacy and answered questions relating to prescriptions and over-the-counter products.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
  • Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.

Counseling Case Manager (Internship)

Butner Stem Middle School Counseling Office
08.2009 - 12.2009
  • Assisting in Counseling Students ages 11-14
  • Assisting in Parent/Teacher Conferences
  • Record Keeping
  • Scheduling Appointments
  • Documentation of Student Records
  • Assisting in group counseling sessions
  • Greeting campus visitors
  • MS Word, Excel, Powerpoint Presentations, and Online Services

Shift Supervisor

CVS/Pharmacy
08.2009 - 12.2009
  • Resolved customer complaints and issues and offered thoughtful solutions to maintain customer satisfaction.
  • Collaborated with management to develop strategies for boosting overall store performance, leading to higher profit margins.
  • Streamlined inventory management, reducing waste and optimizing stock levels for daily operations.
  • Served as a liaison between employees and upper management effectively facilitating communication that bridged any existing gaps.
  • Assisted in budget planning and cost control measures, contributing to the overall financial success of the establishment.
  • Coordinated with vendors regarding product deliveries, guaranteeing adequate supplies available for uninterrupted service provision.
  • Coordinated project workflows for departments.
  • Supervised ongoing daily production phases.
  • Responded to and resolved customer questions and concerns.
  • Improved customer satisfaction rates with consistent quality checks and timely resolution of complaints.
  • Actively participated in promotional events aimed at increasing brand visibility within the community resulting in higher foot traffic volume.
  • Maintained workplace safety by enforcing strict adherence to company policies and industry regulations.
  • Delivered superior training and leadership to teams to boost performance and help team members achieve performance targets.
  • Conducted performance reviews and provided staff with feedback and guidance.
  • Prepared shift summary reports for supervisor and communicated regularly on goals and progress.
  • Managed cash handling procedures, maintaining accuracy in financial transactions and minimizing discrepancies in daily reconciliations.
  • Analyzed sales figures and identified areas for improvement.
  • Coordinated merchandising, promoted new products and increased brand awareness.
  • Strengthened performance metrics tracking and analysis to enhance tactical and strategic company plans.
  • Planned, organized and monitored resources to deliver efficient use of labor, equipment and materials.
  • Front Store and Pharmacy Accounting

Registered Pharmacy Technician

CVS/Pharmacy
05.2006 - 06.2007
  • Demonstrated strong attention to detail when preparing customized compound medications per pharmacist instructions meeting the unique needs of individual patients.
  • Assisted customers in selecting over-the-counter medications, offering guidance on appropriate usage and dosages.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
  • Set up and modified patient profiles to include current medications and insurance details.
  • Liaised with other pharmacies to eliminate issues related to product expiration.
  • Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
  • Managed medication inventory levels effectively, conducting periodic audits to ensure accuracy and prevent shortages or wastage.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Mentored new pharmacy technicians during their training period, fostering a supportive team atmosphere focused on delivering quality patient care.
  • Ensured accurate dosage calculations and proper labeling of medications, improving overall patient safety.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Developed strong relationships with patients through compassionate approach to care delivery, resulting in increased satisfaction scores.
  • Located and measured medications according to prescription information, making modifications as instructed by pharmacists and providers.
  • Effectively managed high-pressure situations by prioritizing tasks focusing on time-sensitive needs.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Counted and labeled prescriptions with correct item and quantity.
  • Entered and processed patients' prescriptions into internal system.
  • Collected co-payments or full payments from customers.

Education

College Transfer

Louisburg College
Louisburg, NC

Associate of Science - Licensed Practical Nursing

Durham Technical Community College
Durham, NC
06.2027

Associate of Applied Science - Health And Human Services

Wake Technical Community College
Raleigh, NC
05.2010

Nursing Assistant

Vance Granville Community College
Henderson, NC
07.2008

High School Diploma -

South Granville School of Health And Life Sciences
Creedmoor, NC
05.2006

Skills

  • Client management
  • Prescription Processing
  • Medical & Pharmaceutical Technology
  • Medication Inventory Management
  • FDA Compliance
  • Medicare, Medicaid Insurance Billing & Claims Processing
  • Customer Service &Relationship Management
  • Data Entry
  • Medical, Pharmacy Prior Authorization & Appeals

Certification

PTCB Certified Pharmacy Technician (ACTIVE)

NCBOP Pharmacy Technician Registration (ACTIVE)

Timeline

Implementation Specialist

S&S Healthcare
08.2023 - Current

Clinical Care Navigator/Insurance Specialist

Biologics By McKesson
03.2022 - 08.2023

Patient Assistance Specialist

Biologics By McKesson
01.2020 - 03.2022

Patient Assistance/Prior Authorization Pharmacy Technician

Duke University Health System
03.2019 - 08.2019

Patient Enrollment Specialist II

C3 HealthcareRX
02.2019 - 01.2020

Certified Pharmacy Technician

UNC Health Care System
08.2018 - 02.2019

Reimbursement Case Manager

Trial Card
06.2018 - 08.2018

Certified Pharmacy Technician

Caremark Specialty Pharmacy
09.2014 - 06.2018

Pharmaceutical Research Pharmacy Technician

PPD/Kelly Services
08.2013 - 09.2014

Certified Pharmacy Technician

Target Pharmacy
07.2010 - 05.2012

Counseling Case Manager (Internship)

Butner Stem Middle School Counseling Office
08.2009 - 12.2009

Shift Supervisor

CVS/Pharmacy
08.2009 - 12.2009

Registered Pharmacy Technician

CVS/Pharmacy
05.2006 - 06.2007

College Transfer

Louisburg College

Associate of Science - Licensed Practical Nursing

Durham Technical Community College

Associate of Applied Science - Health And Human Services

Wake Technical Community College

Nursing Assistant

Vance Granville Community College

High School Diploma -

South Granville School of Health And Life Sciences

Similar Profiles

CREATE PROFILE
Chanice Fairley