Haven Boyles
Goodlettsville,TN
Summary
I am a highly motivated, career focused individual with patient care and team work set as my highest priority. I have worked in the Vanderbilt Ingram Cancer Clinic for the last 5 years as a pharmacy reimbursement specialist/ prior auth technician. I have experience working with clinical staff (providers, pharmacists and nurses) to facilitate patient care and a good understanding of medical terminology.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Pharmacy Reimbursement Specialist
Vanderbilt Medical Center
Nashville, TN
01.2019 - Current
- Submit prior authorizations and appeals to prescription insurance plans for medication approval
- Arrange mail order of outpatient medications
- Process billing investigations for prescription formulary cost and alternatives
- Provide extensive patient care and customer service by tracking upcoming due dates for patients and facilitate synchronization of medication due dates
- Proficient with Microsoft Word and Excel
- Experienced use of EHR system (Epic) to communicate with providers, pharmacist and clinical staff to assist with patient care
- Experienced use of pharmacy system (Erx Enterprise)
- Experienced use of CSMD/ state database to monitor controlled substance fill dates
Pharmacy Technician
Vanderbilt Medical Center East Pharmacy (RETAIL)
Nashville, TN
07.2016 - 01.2019
- Product Dispensing
- Data entry
- Customer Service/ register experience
Pharmacy Technician
Walgreens Pharmacy (RETAIL)
Nashville, TN
05.2014 - 10.2016
- Product Dispensing
- Data entry
- Customer Service/ register experience
Education
High School Diploma -
Greenbrier High School
05.2013
Skills
- Appeals Handling
- HIPAA Compliance
- Claims Processing
- Microsoft Office
- Insurance Verification
- Denial Management
- Medicaid knowledge
- Healthcare Industry
- Managed Care
- Copay Collection
- Customer Service
- Team Collaboration
- Paperwork and documentation
- Billing and Invoicing
Accomplishments
Successfully managed a pilot program that resulted in expansion of the department into other clinics.
Certification
- PTCB, 10080026, 05/31/2025
- TN Pharmacy License, 0000051235, 05/31/2026
Timeline
Pharmacy Reimbursement Specialist
Vanderbilt Medical Center
01.2019 - Current
Pharmacy Technician
Vanderbilt Medical Center East Pharmacy (RETAIL)
07.2016 - 01.2019
Pharmacy Technician
Walgreens Pharmacy (RETAIL)
05.2014 - 10.2016
High School Diploma -
Greenbrier High School