David Montas

Process insurance claims and resolve any discrepancies with insurance companies. Respond to customer inquiries and provide basic information about medications. Maintain accurate patient records and documentation. Operate pharmacy systems for prescription processing and inventory management.

Accountable for managing the day-to-day activities of pharmacy employees through task delegation, shift scheduling, training, and performance reviews. By confirming the correctness of medicine preparation, keeping an eye on inventory, and upholding appropriate storage and safety standards, they guarantee quality control and regulatory compliance. In terms of administration, they work closely with pharmacists, oversee supply ordering, assist with budgeting, and keep records for billing and audits. They also manage escalated customer service issues, act as a vital conduit between employees and management, and strive to enhance patient care and workflow.

Analyzing subjugation claims adjudication with a focus on both rejected and paid claims, emphasizing complex adjudication scenarios involving client-specific benefit plan designs and state-specific medication coverage regulations across represented jurisdictions.