Dawndrell Martin
Sneads,FL
Summary
Healthcare and pharmacy operations professional with 18+ years of experience, including 5 years in Pharmacy Benefit Management (PBM) and extensive experience in claims adjudication, prior authorization, appeals, reimbursement, Medicare Part D, and third-party payer operations. Experienced in reviewing complex healthcare information, identifying missing or inconsistent data, researching cases across multiple systems, applying established requirements, documenting findings, and communicating accurate outcomes. Highly detail-oriented and accustomed to balancing accuracy, consistency, productivity, and quality standards in remote environments. Brings strong healthcare subject-matter expertise and a proven ability to evaluate information against defined criteria—skills directly transferable to AI response evaluation, rubric-based review, data annotation, and AI training.
Overview
1
1
Certification
18
18
years of professional experience
Work History
Member Advocate
VytlOne (formerly Maxor)
Amarillo (Remote), Texas
09.2023 - 05.2026
- Researched and evaluated member benefits, formulary, copay, plan, and prescription information to resolve complex healthcare inquiries accurately and efficiently.
- Resolved prescription claims-processing issues by researching errors and applying appropriate overrides to facilitate accurate claims adjudication.
- Served as a liaison between healthcare providers and pharmacies to support accurate prescription handling and resolution of issues.
- Managed prescription refill requests for patients, providers, and pharmacists while maintaining accuracy and timely service.
- Reviewed information across multiple systems and identified discrepancies requiring additional research, clarification, or corrective action.
- Maintained thorough documentation of research findings and case resolution while adhering to established procedures and quality requirements.
- Consistently met or exceeded productivity targets while maintaining a 90% quality score.
- Maintained an average handle time of less than three minutes while achieving first-call resolution and customer satisfaction goals.
Data Entry Specialist
Aston Carter
Jacksonville (Remote), FL
07.2020 - 06.2023
- Processed Medicare Part D medication request forms and other medication requests for multiple third-party clients through external medical review.
- Reviewed and processed healthcare information in accordance with established requirements and productivity standards.
- Reviewed patient histories to identify information relevant to prior authorization requests and determine whether required information was present.
- Identified missing documentation and contacted physicians to obtain necessary information, including medication history and drugs tried and failed.
- Processed 40+ cases per shift while maintaining required productivity standards.
- Consistently met or exceeded performance expectations for speed, accuracy, and output volume.
- Communicated authorization decisions to members following completion of the review process.
Registered Pharmacy Technician
QHS Healthservices/Nitelines USA Inc.
Marianna, Florida
03.2008 - 10.2017
- Federal contractor for Federal Correctional Institution (FCI), Marianna, FL.
- Assisted pharmacist, doctor, and nurses with ordering, stocking, and dispensing medications across multiple locations.
- Led afternoon pill line and monitored offender responses, recording and reporting changes in physical or emotional condition to medical staff to help prevent medical emergencies.
- Completed inventory and stocking for Pyxis MedStation, printed reports, and performed audits.
- Carried out clerical duties, including stock record maintenance, electronic medical record use, prescription filing, equipment upkeep, and phone coverage.
- Improved quality assurance by reporting quantity discrepancies and error patterns to supervisors per guidelines.
Registered Pharmacy Technician
CVS Pharmacy
Chattahoochee, Florida
05.2008 - 03.2015
- Prepared prescriptions in compliance with state, federal, and HIPAA confidentiality requirements.
- Verified patient insurance and resolved third-party rejections by troubleshooting issues, contacting appropriate companies, submitting manual claim forms, and requesting medication changes from providers.
- Managed inventory for over 300 prescription medications, over-the-counter medications, and medical supplies.
- Maintained patient outreach score above 90% for prescription pick-up notifications, reducing prescriptions returned to stock by 10%.
- Trained new pharmacy technicians during onboarding by serving as first point of contact for operational needs and reinforcing customer service standards, pharmacy rules, and regulations.
- Served over 200 customers daily by completing register transactions, bagging merchandise, processing cash, check, and charge payments, and answering customer questions.
- Removed outdated, damaged, and recalled pharmaceutical merchandise and prepared items for return.
- Made outbound calls to members and providers to gather missing information needed for prescription processing.
- Supported pharmacist with weekly work schedules, rotated technician duties, and balanced coverage around planned leave, improving employee morale.
Education
Associate of Science - Biology
Chipola College
Marianna, FL05-2003
Some College (No Degree) - Biology
Florida Agricultural And Mechanical University
Tallahassee, FLSkills
- Healthcare Subject-Matter Expertise
- Claims Adjudication
- Prior Authorization
- Medicare Part D
- Medicaid & Third-Party Payers
- Medical Terminology & Coding
- Healthcare Data Entry
- Quality & Accuracy Review
- Criteria-Based Information Review
- AI Response Evaluation
- Rubric-Based Evaluation
- Salesforce JIRA RxClaim PA Hub Laker CarePoint
- Microsoft Office Suite
Certification
- Registered Pharmacy Technician - State of Florida Department of Health
Timeline
Member Advocate
VytlOne (formerly Maxor)
09.2023 - 05.2026
Data Entry Specialist
Aston Carter
07.2020 - 06.2023
Registered Pharmacy Technician
CVS Pharmacy
05.2008 - 03.2015
Registered Pharmacy Technician
QHS Healthservices/Nitelines USA Inc.
03.2008 - 10.2017
Associate of Science - Biology
Chipola College
Some College (No Degree) - Biology
Florida Agricultural And Mechanical University