Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
AssistantManager
Loyita Salter

Loyita Salter

Healthcare/Pharmacy Coordination
Lawrenceville,GA

Summary

Innovative care coordinationing professional with several years of diverse experience in different healthcare settings including: retail and specialty pharmacy, clinical, hospital, and managed care remote administrative assistant. Skilled and proficient in addressing and resolving member concerns, access to care, medication adherence/ copay assistance, navigating treatment obstacles, scheduling appointments and procedures, rx entry, data entry, claim resolution and health plan navigation. Adept in FDA/CMS compliance analysis, appeal and grievance filing and documentation and prior authorization processing. Thrive in high-volume environments, resolving complex issues and promoting operational best practices to drive team productivity and exceed service goals. Known for delivering consistent results and adapting to diverse environments to meet objectives. Excels in communication, member satisfaction and customer relationship management. Experienced leader with strong background in guiding teams, managing complex projects,achieving strategic objectives and contributing to organizational growth and success. Exceed expectations in efficient productivity, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence. Knowledge of insurance protocols, medical terminology, ICD 10 codes, CPT/NDC codes, and HIPAA guidelines.

Overview

13
13
years of professional experience

Work History

Advocate Member Service Representative

United Health Group, USA
10.2022 - Current
  • Skilled plans TXMMP/ DUAL Medicare and Medicaid
  • Secondary skilled plans OhioMMP/Dual Medicare and Medicaid, LA Medicaid, TX Medicaid
  • Current Team Komba Compliance Champ
  • Team Roberson Compliance Pre-check Team November 2023 - April 2024
  • Refresh Academy Team June 2024-Sept 2024
  • Cross-trained and provided backup support for organizational leadership.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
  • Promptly responded to inquiries and requests from prospective customers.
  • Increased efficiency and team productivity by promoting operational best practices.
  • Followed up with customers about resolved issues to maintain high standards of customer service.
  • Enhanced customer satisfaction by efficiently resolving issues and addressing concerns.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.

Senior Certified Pharmacy Technician/ T3 Trainer

Walgreens (Boots Alliance)
Duluth, Georgia
01.2014 - 05.2015

Team leader position. Trained, supervised, and coached entry level technicians.

SR. Certified Technician: Makena Specialist

Walgreens Specialty -Jackson Hospital
Montgomery, AL
05.2015 - 03.2017
  • Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
  • Resolved non-routine issues like third-party billing, computer system and customer service issues.
  • Supervised 3 to 6 pharmacy technicians and coordinated day-to-day assignments.
  • Answered patients' questions and troubleshot prescription issues.
  • Makena Specialist: Insurance authorization and distribution (shipping)
  • Coordinated verification and filling of more than 300 daily prescriptions in high-volume retail and hospital specialty pharmacy environment.
  • Set up and modified patient profiles to include current information such as medications and insurance details.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems and locating items.
  • Stocked, labeled, ordered and inventoried medication to keep accurate records.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Advocated for patients' compliance with medication guidelines.
  • Reviewed medication orders.
  • Reviewed and verified customer information and insurance provider information.

SR Certified Pharmacy Technician: Bedside Delivery

Walgreens Specialty Pharmacy- Gwinnett Medical Center
Duluth, GA
08.2012 - 01.2014
  • Advocated for patients' compliance with medication guidelines.
  • Prepared intravenous solutions, admixtures, respiratory drugs and other solutions using aseptic techniques.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Maintained relationships with physicians.
  • Delivered discharge medication bedside to patients

Senior Certified Pharmacy Technician

Walgreens Pharmacy
Troy, Alabama
11.2007 - 07.2012
  • Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
  • Resolved non-routine issues like third-party billing, computer system and customer service issues.
  • Supervised 3 to 6 pharmacy technicians and coordinated day-to-day assignments.
  • Answered patients' questions and troubleshot prescription issues.
  • Maintained proper drug storage procedures, registries, and records for controlled drugs.
  • Reviewed and verified customer information and insurance provider information.
  • Reviewed medication orders.
  • Advocated for patients' compliance with medication guidelines.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Maintained relationships with physicians.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems and locating items.
  • Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Set up and modified patient profiles to include current information such as medications and insurance details.
  • Coordinated verification and filling of more than 300 daily prescriptions in high-volume pharmacy environment.

Education

Associates Of Applied Science - Biology

Troy University
Troy, AL

Skills

  • Patient Profile Setup
  • Prescription Order Verification
  • Reviewing Prescriptions
  • FDA Compliance/CMS Compliance
  • Prescription Refill Fulfillment
  • Drug Inventory Management
  • Health Insurance Benefits and Eligibility
  • Medication Documentation
  • Reviewing Patient Information
  • Answering and Routing Calls
  • Organization and Prioritization
  • Insurance Claim Processing Software
  • Inventory Purchasing
  • Information Documentation
  • Prescriptions Management
  • Error Verification
  • Active Listening
  • Medical and Prescription claims review
  • High-Volume Environments
  • Legacy Inventory Management Systems
  • Reconciling Paperwork
  • Customer Needs Assessments
  • Resolving Complaints
  • Patient Data Management Systems
  • Systems Analysis
  • HIPAA
  • Effective communication
  • De-escalation techniques
  • Compliance quality assurance
  • Professionalism and integrity
  • Complaint handling and grievance filing
  • Attention to detail
  • Exceptional communication
  • Problem-solving abilities
  • Customer service excellence
  • Multitasking Abilities
  • Calm under pressure

Additional Information

References:

Nrendin Sule
Walgreens Pharmacy- Duluth GA
1490 Pleasant Hill rd 30096
770-921-9976

Amy Setzer
Walgreens Specialty
Jackson Hospital- Montgomery AL
334-559-0280
Weaveak@gmail.com
**She would remember me by Koko**

Tiffany Coleman -Pharmacy Manager
334-332-4184
tipplc29@yahoo.com
**She would remember me by Koko**

Amanda Moore- Pharmacy Manager
Walgreens Community Pharmacy- Troy Al
100 Elba Hwy 36081
1st employer/trainer
334-808-4282
**She would remember me by Koko**

Jennifer Komba- Current Supervisor UHG

Phone 1(613)383-4230

C&S + DSNP

Ricky Jackson- Previous Supervisor UHG

Phone 1(952)202-9893

C&S + DSNP

Thank you for your consideration!

Timeline

Advocate Member Service Representative

United Health Group, USA
10.2022 - Current

SR. Certified Technician: Makena Specialist

Walgreens Specialty -Jackson Hospital
05.2015 - 03.2017

Senior Certified Pharmacy Technician/ T3 Trainer

Walgreens (Boots Alliance)
01.2014 - 05.2015

SR Certified Pharmacy Technician: Bedside Delivery

Walgreens Specialty Pharmacy- Gwinnett Medical Center
08.2012 - 01.2014

Senior Certified Pharmacy Technician

Walgreens Pharmacy
11.2007 - 07.2012

Associates Of Applied Science - Biology

Troy University
Loyita SalterHealthcare/Pharmacy Coordination