Jennifer Squires
Las Vegas,NV
Summary
Hardworking Sr. Pharmacy Auditor with more than 17 years of experience. Always a team player with strong organizational skills and work ethic. Ability to handle multiple projects simultaneously with a high degree of accuracy and efficiency.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Sr. Pharmacy Auditor
OptumRx
02.2022 - Current
- SME (Subject Matter Expert)-Training new team members on pharmacy audit procedures, reports, phone etiquette and any follow up questions they may have
- Identified and corrected discrepant claims pertaining to Fraud, Waste and Abuse.
- POET Certified
Lead Pharmacy Services technician
United HealthCare
03.2016 - 02.2022
- Receive incoming prior authorizations from providers and review medications according to FDA guidelines on the Commercial and Medicaid formularies to meet all compliance measures
- Input Medicaid and Commercial Appeals into the RX claims into the system
- Answer incoming calls from providers and pharmacies that need assistance with prior authorizations or processing claims
- On call technician during evenings and weekends for patients needing pharmacy assistance after hours
- Assist manager in interviewing/training new hires and well as assisting the technicians with questions or escalated issues and supervisor calls
- Create and maintain teamwork assignments, workflow and schedules
Customer Service Representative/ Pharmacy lead Assistant
Insure Monkey (Nevada Health Co Op)
01.2015 - 03.2016
- Quoted medical benefits and verified eligibility to providers and hospitals for patients
- Provided claim status to providers on medical claims
- Assisted pharmacies with pharmacy claims and eligibility
- Received and verified premium payments for the member’s insurance premiums
- Trained new employees on the system and the requirements pertaining to the job.
Senior Certified Pharmacy Technician
Walgreens Pharmacy
04.2007 - 01.2015
- Trained new employees on the pharmacy tasks, duties and responsibilities as a technician and pharmacy workflow
- Worked closely with pharmacists and used medication software to safely and accurately dispense medication
- Efficiently answered multi-line phone and processed high volume of prescriptions
- Managed drug inventory by ordering necessary medications, checking inventory, supplies and verifying deliveries
- Regularly entered prescription and insurance billing information into patient profiles and resolved insurance rejections and other billing issues
Education
Associates Degree - Pharmacology
High Tech Institute
Las Vegas, NVHigh School Diploma -
Skills
- HIPAA Compliance
- Documentation Review
- Medication Management
- Auditing Techniques
- Pharmaceutical knowledge
Certification
- Nevada State Board of Pharmacy license, PT07815
- Certified Pharmacy Technician (PTCB) license, 490107010045645
References
References available upon request.
Timeline
Sr. Pharmacy Auditor
OptumRx
02.2022 - Current
Lead Pharmacy Services technician
United HealthCare
03.2016 - 02.2022
Customer Service Representative/ Pharmacy lead Assistant
Insure Monkey (Nevada Health Co Op)
01.2015 - 03.2016
Senior Certified Pharmacy Technician
Walgreens Pharmacy
04.2007 - 01.2015
Associates Degree - Pharmacology
High Tech Institute