HILARY MCFARLAND

• Input all patient data regarding claims and prior authorizations into system accurately.
• Verified eligibility and compliance with authorization requirements for service providers.
• Fielded telephone inquiries on authorization details from plan members and medical staff.
• Triaged unscheduled and emergency authorizations, directing submissions to appropriate personnel for rapid response.
• Escalated appeal requests by providers to Chief Medical Officer.
• Tracked referral submission during facilitation of prior authorization issuance.

• Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
• Implemented care and efficiency improvements to support and enhance office operations.
• Performed clerical duties, such as word processing, data entry, answering phones and filing.
• Taught patients about medications, procedures and care plan instructions.
• Collected and documented patient medical information such as blood pressure and weight.
• Resolved issues and inquiries from plan participants regarding pharmaceutical benefits and coverage.

• Resolved non-routine issues like third party billing, computer system and customer service issues.
• Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
• Processed over 650 prescriptions per day in busy pharmacy achieving decreased customer wait times and maintaining excellent customer satisfaction.
• Coordinated with physicians and insurance agency representatives for speedy resolution of prescription discrepancies.
• Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
• Verified patient data and billing information to discover and resolve erroneous bills due to system errors.
• Set up and modified patient profiles in PioneerRx to include current information such as medications and insurance details.

• Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
• Prepared bills for insurance companies and submitted required paperwork.
• Liaised with other pharmacies to eliminate issues related to product expiration.
• Counted, measured and compounded medications following standard procedures.
• Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.

• Supervised 4 pharmacy technicians and coordinated day-to-day assignments.
• Developed and implemented improvements to pharmacy organization system within PioneerRX increasing productivity by 65% for all compound prescription processing.
• Coordinated workshops for employees to better understand company mission, streamlining daily activities and aligning worker and company priorities.
• Verified long-term staff excellence by implementing updated and continuous training initiatives such as online modules, interactive programs and webinars with PioneerRX.
• Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
• Counted and labeled prescriptions with correct item and quantity.

• Resolved problems with areas such as communication and billing that could negatively impact cancer care treatment plan.
• Managed prescriptions by sending electronic requests for new medications and refills as well as obtaining insurance authorization for chemotherapy and radiation treatments.
• Monitored logistics for patient intake and implementation of proposed courses of treatment.
• Coordinated charitable, government and community resources for patients.
• Worked with patients and families to develop future plans and discuss care actions.

• Acted as subject matter expert, answering internal and external questions and inquiries pertaining to pharmacy prior authorizations.
• Communicated effectively with members of operations, finance and clinical departments.
• Tracked pending authorizations within pharmacist review department to resolve discrepancies and avoid continued hinderance in patient care.
• Followed up on denials for medication authorization by triaging appeal cases and requesting additional information per Chief Medical Officer.

• Ensured proper entry and processing of patients' prescriptions into internal system.
• Communicated instructions to patients or caregivers.
• Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
• Reviewed and verified customer information and insurance provider information.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems and locating items.
• Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.

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• Answered incoming phone calls and addressed questions from customers and healthcare providers.