JULIET AVILA
Albuquerque,NM
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Prior Authorization Customer Service Rep
CapitalRx
New York , New York
2024.03 - 2024.09
- Answered all calls with a professional tone and direction.
- Provided information calmly and efficiently average 7.5 min call times
- Maintaining quality care for Commercial, Medicare and Medicaid members
- Initiated warm transfers when necessary
- Consistently returned callback promises to patients, providers and prescribers
- Initiated prior authorizations over the phone
Patient Support Advocate
Shields Health Solutions
Stoughton , Massachusetts
2023.09 - 2024.03
- Separated workflow based on urgency and time frame
- Utilized Epic Willow to collaborate with hospital staff and liaison
- Conducted Financial assistance and eligibility research for grants, manufacturing applications and pharmacy coupons/copay cards
- Initiated follow up calls based on appropriate turnaround times
Prior Authorization Specialist - Medicare D
Prime Therapeutics
Remote
2019.04 - 2023.09
- Responsible for communicating with any/all appropriate medical professionals within medical office
- Communicates any information and obtains information that is missing, such as documentation, explanations, chart notes, patient, and provider information
- Maintains HIPPA and Protected Health Information by following all guidelines when making outbound calls and sending notification
- Responsible for organizing, processing and documenting utilization reviews
- Entered prior authorizations accurately in claims system to ensure appropriate claims will adjudicate
- Maintaining client specific turnaround times and quality of 95% or better
- Managed workflow and distributed work based on urgency
- Collaborate with internal teams to provide consistency of review completion
- Mentored, answered questions, audited requests, and provided feedback to HCSC new hire training class
- Maintained compliance with patient privacy and security regulations such as HIIPA
Pharmacy Technician
Lovelace Medical Center
2018.06 - 2018.08
- Completed wide range of pharmaceutical tasks under the direct supervision of a certified pharmacy technician in-patient (Completed 115.5 hours total, 60.5 IV hours)
- Produced and fulfilled orders in compliance to USP Sterile Compounding
- Prepared and distributed medications (Maintained Pyxis)
- Performed maintenance of drug inventory
- Actively adhered to all policies, procedures, and regulations to ensure patient safety and compliance
Pharmacy Technician
Best Buy Pharmacy
2018.05 - 2018.06
- Completed wide range of pharmaceutical tasks under the direct supervision of a registered pharmacist in retail pharmacy setting (Completed 115.5 hours total)
- Collaborated with pharmacy team members in accordance with state and federal regulations to provide excellent patient/customer experiences
- Packaged and fulfilled orders
- Utilized pharmacy software/systems to obtain patient and drug information and process prescriptions
- Managed inventory
- Excelled in organization and problem solving
Education
Pharmacy Technician Certification -
New Mexico Community College
Albuquerque, NM08.2018
Associate of Arts -
Central New Mexico Community College
Albuquerque, NMCertificate in Health, Wellness & Public Safety -
Central New Mexico Community College, Mexico Community College
Albuquerque, NM12.2017
High School Diploma -
Albuquerque Institute of Mathematics And Science
05.2017
Skills
- Data Entry
- New-hire training
- Prioritizing workload
- Medical Terminology
- Communication
- Process Optimization
Websites
Certification
- State License NM, CPhT - Certified Pharmacy Technician #30081878
- PTCB Nationally Certified #PT00012522
Timeline
Prior Authorization Customer Service Rep
CapitalRx
2024.03 - 2024.09
Patient Support Advocate
Shields Health Solutions
2023.09 - 2024.03
Prior Authorization Specialist - Medicare D
Prime Therapeutics
2019.04 - 2023.09
Pharmacy Technician
Lovelace Medical Center
2018.06 - 2018.08
Pharmacy Technician
Best Buy Pharmacy
2018.05 - 2018.06
Pharmacy Technician Certification -
New Mexico Community College
Associate of Arts -
Central New Mexico Community College
Certificate in Health, Wellness & Public Safety -
Central New Mexico Community College, Mexico Community College
High School Diploma -
Albuquerque Institute of Mathematics And Science
- State License NM, CPhT - Certified Pharmacy Technician #30081878
- PTCB Nationally Certified #PT00012522
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