Jarquis Jones
Fall River,MA
Summary
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
16
16
years of professional experience
Work History
Pharmacy Support Analyst
Blue Cross Blue Shield of Massachusetts
05.2018 - Current
- Performs regular quality review and maintenance of Medicare Part D Explanation of Benefits (EOB) transition letters, formulary documents, and other member and marketing communications as needed
- Responsible for the daily review and oversight of paid, rejected, and transition claims reporting
- Responsible for reviewing various Medicare Part D reporting from the PBM and communicating findings to senior team members
- Supports Medicare oversight and validation testing of regular formulary and claims adjudication changes
- Knowledgeable in BCBSMA pharmacy programs and formulary policies.
Pharmacy Operations Supervisor
Blue Cross Blue Shield of Massachusetts
11.2016 - 05.2018
- Knowledgeable in BCBSMA pharmacy programs and formulary policies
- Pharmacy Operations subject matter expert for Pharmacy Operations associate call reporting, working in Cisco Unified Intelligence Center and Cisco United CCE Administration systems
- Oversee, coordinate and monitor associate call resource allocation, to meet all applicable business and regulatory service level requirements
- Responsible for all Pharmacy Operations associate production reporting for Commercial, Medicare, Medical and Home Infusion lines of business
- Provide ad hoc reporting to Pharmacy Operation leadership to identify trends pertaining to associate performance and utilization management for Commercial, Medicare, Medical and Home Infusion lines of business
- Provide oversight and one on one coaching with associates, to improve production and operating efficiencies and increasing provider, member, and associate satisfaction
- Primary point of contact for day to day associate questions and support with technical and production functions of the department; and resolving Pharmacy related inquiries from internal external business areas
- Responsible for monthly Pharmacy Operations associate quality control; reviewing and evaluating Pharmacy Operations associate calls/postings against quality and compliance standards.
Pharmacy Analyst
Blue Cross Blue Shield of Massachusetts
06.2012 - 11.2016
- Medical policy and plan design interpretation
- Receive, process, and archive providers fax and phone authorization requests for Medicare Part D, HIT, and Medi-cal
- Review and interpret members eligibility, claim history, and Pharmacy Program information using the PBM claims software to provide information to both internal and external clients
- Serve as a liaison to Member Services and other internal clients for support on Pharmacy benefit
Receptionist
The Shaw Group
04.2011 - 05.2012
- Book Conference Rooms using Microsoft Outlook for internal clients
- Clerical Duties
- Sign for Packages from various couriers such as UPS, Fed EX and USPS and delivering mail to the appropriate internal clients
- Check in external clients and notify the appropriate persons upon arrival.
Executive Assistant
Boggs Properties
02.2010 - 01.2011
- Makes appointments and arranges meetings
- Performs a variety of office duties such as data entry, filing, sending faxes and e-mails
- Ordering budget items, renewing memberships, and preparing expense
- Light bookkeeping
Receptionist/ Security Officer
Millennium Pharmaceutical
11.2008 - 06.2009
- Directing visitors to their destinations, sorting mail, answering incoming calls on multi-line telephones, and filing records
- Answering visitor inquiries about the company and its products or services
- Keyboarding/data entry and performing a variety of other office tasks, such as faxing and emailing.
Switchboard Operator/Receptionist
Wentworth Institute
04.2007 - 10.2008
- Assist in the operation of a large telephone switchboard and Routing all incoming and outgoing telephone calls placed through the switchboard
- Sign and Log packages into the building from Fed Ex, DHL and various couriers
- Fax and e-mail documents for faculty members
- Assist students with questions and concerns regarding the school.
Education
Certificate Program - Certified Nursing Assistant/Home Health AId
08.2023
High School Diploma - Health Care
05.2015
Skills
- Customer Service
- Attention to Detail
- Medical Terminology Knowledge
- Compassionate
- Quick Problem Solver
- Patient-Focused Care
- Infection Control
- Emotional Intelligence
- Health Insurance Verification
- Records Management
- Basic Nursing Care
- Adaptable
- Healthcare Expertise
Timeline
Pharmacy Support Analyst - Blue Cross Blue Shield of Massachusetts
05.2018 - Current
Pharmacy Operations Supervisor - Blue Cross Blue Shield of Massachusetts
11.2016 - 05.2018
Pharmacy Analyst - Blue Cross Blue Shield of Massachusetts
06.2012 - 11.2016
Receptionist - The Shaw Group
04.2011 - 05.2012
Executive Assistant - Boggs Properties
02.2010 - 01.2011
Receptionist/ Security Officer - Millennium Pharmaceutical
11.2008 - 06.2009
Switchboard Operator/Receptionist - Wentworth Institute
04.2007 - 10.2008
Health Care- EDU - Certificate Program, Certified Nursing Assistant/Home Health AId
Thayer Academy - High School Diploma, Health Care
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