Jenny Lopez
Berwyn,IL
Summary
Results-driven professional recognized for meticulous attention to detail and effective workload prioritization. Skilled in managing complex workflows, enhancing client interactions, and ensuring seamless integration of operational processes.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Associate Employer Installation Specialist
OptumRx
05.2019 - Current
- Executed detailed setup of employer plans and billing processes, ensuring seamless integration into company databases.
- Oversaw data management tasks, ensuring accuracy in loading contract amendments and maintaining up-to-date benefits records.
- Executed data load audits to guarantee compliance with quality reporting and regulatory standards.
- Analyzed and addressed technical installation issues to enhance client satisfaction and streamline support processes.
- Engaged with internal teams, including data analysts and project leads, to streamline and improve operational workflows.
- Led initiatives to establish and refine billing structures. Oversaw revisions to structural frameworks to enhance efficiency. Resolved complex structural issues through thorough research and analysis. Managed database loading and coordinated preparation of essential plan materials, including administrative documents and customer education materials.
- Consistently met or exceeded project deadlines while maintaining high-quality workmanship standards.
- Coordinated and managed over 500 new client installations within the year, prioritizing resolution of project issues and enhancing client satisfaction.
Senior Prior Authorization Specialist
OptumRx
01.2014 - 05.2019
- Managed efficient processing of prior authorization requests, maintaining compliance with established policies and regulations.
- Analyzed medical records to ensure accurate determination of medication eligibility.
- Engaged with healthcare providers to gather critical information, ensuring timely processing of authorization approvals.
- Facilitated resolution of complex issues during escalated calls, prioritizing client satisfaction throughout the process.
- Managed high-volume prior authorization workflows, addressing complex cases involving specialty medications and costly medical procedures.
- Executed detailed issue analysis and applied effective problem-solving techniques to boost first-call resolution rates.
- Monitored and updated knowledge of product and service changes to ensure informed decision-making.
- Collaborated with healthcare providers to obtain necessary documentation for patient medication approvals.
- Streamlined communication processes by managing a high volume of over 150 customer calls per day.
Education
Associate of Science - Health Sciences
Morton College
Cicero, IL05-2006
Skills
- Customer relationship management
- Workload prioritization
- Statistical analysis
- Team-oriented collaboration
- Analytical problem-solving
- Meticulous attention to detail
- Prioritization and planning skills
- Analytical problem-solving
- Strong verbal communication
- Proficient in computer applications
- Adaptability in dynamic environments
- Performance analysis
Certification
- Certified Pharmacy Technician
Timeline
Associate Employer Installation Specialist
OptumRx
05.2019 - Current
Senior Prior Authorization Specialist
OptumRx
01.2014 - 05.2019
Associate of Science - Health Sciences
Morton College