Kayleigh Vieira
Warwick,RI
Summary
Driven analytical professional with combined 3+ years of experience in retail pharmacy and corporate healthcare setting, and 1+ year experience in pharmacy data analytics. Enjoys using relational databases to discover additional information about audit trends, payer dynamics, as well as developing and improving processes that are used on a daily and monthly cadence. Eager to gain knowledge using analytics in other fields.
Overview
5
5
years of professional experience
Work History
Audit Analyst
CVS HEALTH CORPORATION
Cumberland, RI
11.2023 - Current
- Completes ad-hoc tasks using TeraData, Oracle, and/or Access Databases to obtain prescription history, therapeutic classes of medications, claim information, etc.
- Facilitates Month End claim reconciliation to determine which audit claims should be written off, using certain key metrics to ensure a specific $ amount is reached.
- Works with audit coordinators to pull data for the payers they are assigned to so they can put together presentations regarding audit/payer trends.
- Works with payer contracts to put together an audit contract matrix that houses all audit verbiage in contracts, which allows us to track audits and ensure payers are continuing to audit within their contractual rights.
- Presented audit results to management teams, delivering information in non-technical terms for easy understanding.
Sr. Coordinator
CVS HEALTH CORPORATION
Cumberland, RI
04.2021 - 11.2022
- Facilitated audit requests from several payers.
- Responded to audit requests in a timely manner.
- Communicated with pharmacy staff to ensure that audit documentation was received.
- Worked on various projects with team members and other teams in order to improve current processes.
- Worked the Gross Margin process monthly in order to help eliminate audit risk and has documented the entire Gross Margin Process to include in the Training Matrix.
Pharmacy Technician
Wal-Mart Pharmacy
Fairhaven, MA
10.2018 - 04.2021
- Supported pharmacological services by entering prescription data, filling 400+ medications per day, and ensuring the pharmacy was fully stocked.
- Helped healthcare providers and patients by greeting them in person and by phone, answering questions and requests, and referring inquiries to the pharmacist.
- Worked with Third Party Insurance companies to fix adjudication errors.
Education
Bachelor of Science - Biology And Forensic Science
University of New Haven
West Haven, CT05-2018
Skills
- Risk Mitigation Strategies
- Root Cause Analysis
- Organization
- Critical Thinking
- SQL
- Microsoft Office Applications
References
References available upon request.
Timeline
Audit Analyst
CVS HEALTH CORPORATION
11.2023 - Current
Sr. Coordinator
CVS HEALTH CORPORATION
04.2021 - 11.2022
Pharmacy Technician
Wal-Mart Pharmacy
10.2018 - 04.2021
Bachelor of Science - Biology And Forensic Science
University of New Haven