Summary
Overview
Work History
Education
Skills
Certification
Timeline

Kelly Miller

Summary

Experienced and licensed pharmacy technician with a strong background in prescription data entry. Possessing national pharmacy technician certification, well-versed in pharmacy processes and has a keen eye for accuracy. Committed to providing excellent customer service, dedicated to identifying and troubleshooting problematic issues and effectively relaying them to member benefits according to plan. Currently seeking a full-time role that offers professional challenges and allows leveraging interpersonal skills, effective time management, and problem-solving expertise.

Overview

10
10
years of professional experience
12
12
Certification

Work History

Prior Authorization Pharmacy Technician (Seasonal)

TCW GLOBAL
10.2024 - 12.2024
  • Verify eligibility and drug coverage under the plan benefit design to ensure accurate claims processing
  • Triage clinical review processes for prior authorization requests according to established protocols
  • Review non-specialty drug prior authorizations and similar requests using criteria, claims history, and plan benefit rules
  • Organize and prioritize multiple requests to ensure timely management of prior authorization cases
  • Build and adjust authorizations within the claims adjudication system following protocols
  • Utilize your pharmacy technician experience to navigate drug products, formulations, and perform basic calculations for accurate claims adjudication
  • Critically assess and synthesize multiple workflows to make sound clinical decisions
  • Collaborate with teams to coordinate outreach, address questions/escalations, and guide processes for timely and appropriate medication coverage
  • Evaluate member clinical situations against medication policies to determine approval or escalate to a Pharmacist for denial

Clinical Pharmacy Technician

Magellan Rx/Prime Therapeutics
06.2022 - 10.2024
  • Responsible for high volume in-bound call center serving calls from Members, Pharmacies and Prescribers for commercial pharmacy benefits management business
  • Evaluate and authorize approval of prior authorization requests from prescribers received by telephone and/or facsimile using client clinical criteria
  • Research, resolve and document prior authorization outcomes in pharmacy system
  • Communicate selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists
  • Escalate requests to Pharmacist when request requires extensive clinical review or denial
  • Research, resolve and document physician or client inquiries and grievances, provide verbal or written results to client, prescriber, and provider
  • Process medications for mail order
  • Perform other duties as required
  • Abide by all policy, rules and duties of the Company, and State and Federal laws

Certified Pharmacy Technician

BAY PHARMACY
07.2021 - 06.2022
  • Calculate and record formula for non-sterile compounding
  • Follow all current rules and duties of the Pharmacy, Company, and State and Federal laws
  • Quickly and accurately fill all medication orders and arrange them neatly for the Pharmacist to check
  • Assist with inventory and ordering of pharmaceuticals
  • Performs other duties as assigned
  • Greet all customers and provide them with prompt and courteous service and assistance

Certified Pharmacy Technician

ATKINS PHARMACY
03.2021 - 06.2021
  • Follow all current rules and duties of the Pharmacy, Company, and State and Federal laws
  • Perform other duties as assigned by manager
  • Quickly and accurately fill all medication orders
  • Provided excellent customer service by addressing inquiries, resolving issues, and providing medication information
  • Assisted patients with insurance claims processing ensuring accurate billing information was provided
  • Ensured compliance with HIPAA regulations when handling sensitive patient information
  • Collaborated with pharmacists to verify prescription information, resolve medication discrepancies, and provide patient counseling

Certified Pharmacy Technician

WALGREEN'S PHARMACY
01.2019 - 03.2021
  • Assisted with quality improvement initiatives, inventory and ordering of pharmaceuticals
  • Followed all current rules and duties of the Pharmacy, Company, and State and Federal laws
  • Quickly and accurately filled all medication orders and arranged them neatly for the Pharmacist to check
  • Managed time efficiently, working effectively with other team members
  • Perform other duties as assigned by your management team

Certified Pharmacy Technician

BAY PHARMACY
02.2015 - 01.2019
  • Quickly and accurately fill all medication orders and arrange them neatly for the Pharmacist to check
  • Follow all current rules and duties of the Pharmacy, State and Federal laws
  • Produce pharmaceuticals in the form of custom formulas under the guidance of the Pharmacist
  • Complete paperwork and clean instruments connected with the compounding process
  • Keep inventory of current medications and process orders for new medication
  • Manage time effectively, meet personal goals and objectives while working effectively
  • Greet all customers and provide them with prompt and courteous service and assistance

Customer Service Representative

WALGREEN'S
02.2013 - 02.2015
  • Provided strong customer service and assistance
  • Performed other duties assigned by the Assistant Manager and Store Manager
  • Assisted with new hire training
  • Stocked shelves

Education

Bachelor's - Business Management

UNIVERSITY OF PHOENIX
09.2011

Skills

  • Insurance Verification
  • Clinical Pharmacy Experience
  • HIPAA regulations compliance
  • Pharmaceutical calculations
  • FDA compliance
  • Patient confidentiality
  • Team collaboration
  • Pharmacy operations
  • Confidentiality and HIPAA
  • Regulatory compliance
  • Insurance billing

Certification

  • National Association of Boards of Pharmacy, 1229203
  • Pharmacy Technician Certification Board, 30010460, 05/31/26

Timeline

Prior Authorization Pharmacy Technician (Seasonal) - TCW GLOBAL
10.2024 - 12.2024
Clinical Pharmacy Technician - Magellan Rx/Prime Therapeutics
06.2022 - 10.2024
Certified Pharmacy Technician - BAY PHARMACY
07.2021 - 06.2022
Certified Pharmacy Technician - ATKINS PHARMACY
03.2021 - 06.2021
Certified Pharmacy Technician - WALGREEN'S PHARMACY
01.2019 - 03.2021
Certified Pharmacy Technician - BAY PHARMACY
02.2015 - 01.2019
Customer Service Representative - WALGREEN'S
02.2013 - 02.2015
UNIVERSITY OF PHOENIX - Bachelor's, Business Management

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Kelly Miller