Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality
Answered incoming phone calls and made outbound calls addressed questions members
Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists
Reimbursement Specialist
Children's Hospital Of Richmond At VCU
06.2018 - 08.2022
Prevented delays and claim denials by correcting information prior to submission
Completed prior authorization forms and appeals documentation
Improved revenue collection pertaining to high cost medications that require prior authorization
Initiated, followed-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, secured fax and/or email
Worked closely with nursing and physicians in order to obtain required documentation for prior authorization and billing
Carried out benefit investigation and coordinated Patient Assistance Programs and/or copay cards for patients with high co-pays or those without insurance coverage
Consulted with various health insurance company representatives to complete claims processing, resolve concerns, and reconcile payments
Holiday Clerk Assistant
USPS, United States Postal Service
09.2020 - 01.2021
Drove customer loyalty and consistent sales through friendly service and knowledgeable assistance
Verified transactions, product orders and shipping dates and entered information into databases and reports
Weighed letters and packages and calculated costs based on classification, weight, and destination
Used automated mail processing equipment to sort and collate mail
Communicated decision to patients, physicians, physician's office staff, medical management staff and/or pharmacists
Researched, resolved and documented prior authorization outcomes in pharmacy system
Communicated selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to patients,physicians, physician's office staff, medical management staff and/or pharmacists
Researched, resolved and documented physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management
Certified Pharmacy Technician
CVS Pharmacy
04.2013 - 02.2018
Processed and submitted insurance claims into the pharmacy system
Provided quality customer service to patients, insurance companies,pharmacist,nurses,and other healthcare related parties
Performed all tasks in a safe manner that is consistent with corporate policies as well as state and federal laws
Communicated with prescribers to verify medication dosages, refill authorizations, and patient information
Counted, measured and compounded medications following standard procedures
Stocked, labeled, and inventoried medication to keep accurate records
Shipping and Receiving Clerk
Jacobson Companies
08.2012 - 01.2014
Packed, sealed, labeled, and affixed postage using FedEx and Ups World ship online programs for shipping
Moved freight, stock or other materials to and from storage or production areas, loading docks, or containers, by hand or using powered industrial trucks
Made arrangements for pick-up by the carriers
Verified inventory computations by comparing them to physical counts of stock, and investigate discrepancies and adjust errors
Answered phones, checked in drivers and ordered follow ups on undeliverable items
Drafted and managed work and shipping orders, bills of lading, and shipping route materials for accurate and compliant recordkeeping
Verified transactions, product orders and shipping dates and entered information into databases and reports