CHRISTINE CALDERON
Pico Rivera,CA
Summary
Pharmacy operations leader with 14+ years of experience, including hands-on management of pharmacy audits, prescription processing, pharmacy claims troubleshooting, insurance eligibility, coordination of benefits, reimbursement issues, compliance, staff supervision, and operational problem resolution. Experienced in working with pharmacy claims, payer requirements, documentation, and cross-functional stakeholders.
Overview
1
1
Language
15
15
years of professional experience
Work History
Notary Public / Independent Business Owner
NOTARY SIGNING SOLUTIONS
11.2024 - Current
- Scheduled appointments, communicated with clients, managed documentation, and secured confidential records for independent notarial services.
- Confirmed identity of signers during notary appointments. and notarized loan documents for mobile signing appointments.
- Verified identities, ensured document completion, maintained required records, and coordinated service delivery timelines.
- Prepared acknowledgments, jurats, and affidavits following state notary requirements.
- Managed and organized signing appointments for clients and partners. with clients, title companies, and signing services.
Lead Pharmacy Technician / Pharmacy Operations Lead
BRIGHT LA MIRADA PHARMACY
La Mirada, California
02.2012 - 09.2026
- Led daily technician workflow and supported accurate, timely processing of approximately 100–130 prescriptions per day in a high-volume community pharmacy.
- Coordinated pharmacy audits, integrating findings with daily prescription and claims workflows to ensure compliance and operational efficiency.
- Managed pharmacy audits at the community pharmacy, serving as the operational point of contact throughout audit activities.
- Investigated pharmacy claim rejections and insurance eligibility issues, collaborating with payers and prescribers to resolve discrepancies and enhance claim processing.
- Identified primary insurance coverage, reviewed patient eligibility and plan requirements, and helped resolve claim adjudication and reimbursement-related obstacles.
- Coordinated prior authorization requests, formulary alternatives, preferred NDC selections, vacation overrides, and medication coverage changes with pharmacists, providers, and insurance representatives.
- Escalated recurring system and billing problems, partnering with pharmacy staff and IT support to restore workflow and minimize service disruptions.
- Trained and supervised pharmacy technicians, delegated assignments, monitored work completion, and served as the primary escalation contact for staff and patient concerns.
- Communicated complex claim and coverage outcomes to patients, prescribers, and other stakeholders; de-escalated complaints and coordinated practical resolutions.
- Maintained patient profiles, prescription information, and insurance records in Rx30; supported accurate documentation and confidentiality requirements.
- Coordinated inventory, vendor interactions, purchasing, and front-end operations while balancing service, accuracy, and compliance priorities.
Education
High School Diploma -
Whittier High School
Whittier06-2005
Skills
- Pharmacy Audit Management Pharmacy Operations Pharmacy Claims Processing Audit Readiness PBM & Payer Coordination Claims Review Insurance Eligibility Coordination of Benefits Reimbursement Troubleshooting Claims Rejections & Denials Prior Authorizations Fraud, Waste & Abuse Awareness Regulatory Compliance Issue Escalation Staff Leadership Rx30
- Pharmacy Technician Certification (CPhT; verify current status) Fraud, Waste & Abuse Training (2026) Notary Public Rx30 Microsoft Excel Pharmacy insurance eligibility and billing systems
- Pharmacy claims
- Insurance adjudication
- Prior authorizations
- Inventory Management
Personal Information
Title: PHARMACY OPERATIONS & CLAIMS COMPLIANCE LEADER
ADDITIONAL EXPERIENCE
- SAI | Medical Interpreter (English–Spanish)
- Provided accurate bilingual interpretation between Spanish-speaking patients and healthcare professionals to support effective clinical communication and patient understanding.
- Clarified medical terminology, treatment plans, care instructions, and follow-up information while preserving the meaning and intent of communications.
- Served as a communication liaison among patients, clinicians, and care teams to help resolve questions and reduce misunderstandings during healthcare encounters.
- Collaborated with multidisciplinary healthcare personnel to support coordinated, culturally sensitive patient interactions.
- Maintained confidentiality of sensitive patient and medical information and upheld professional standards in healthcare settings.
TARGET ROLE ALIGNMENT
Relevant strengths: direct pharmacy audit management, pharmacy claims lifecycle, payer interactions, operational issue investigation, compliance documentation, staff management, stakeholder communication, and process improvements.
Languages
Spanish
Native/ Bilingual
Timeline
Notary Public / Independent Business Owner
NOTARY SIGNING SOLUTIONS
11.2024 - Current
Lead Pharmacy Technician / Pharmacy Operations Lead
BRIGHT LA MIRADA PHARMACY
02.2012 - 09.2026
High School Diploma -
Whittier High School