Mary Scott
Buffalo,NY
Summary
Assisted teams in resolving customer issues through effective problem-solving techniques. Supported organizational efforts by managing multiple tasks simultaneously. Contributed to team success by collaborating with colleagues to achieve business objectives. Open to relocation anywhere in the US for any employer.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Senior Associate, RX Specialist
Ametros Financial
Buffalo, NY
06.2025 - Current
- Oversaw medication management for injured workers, ensuring compliance with jurisdictional guidelines and payer protocols. Acted as a primary liaison among pharmacies, providers, claims adjusters, and internal teams to enhance operational efficiency.
Specialty/Oncology Prior Authorization Technician
Kelly Services/Excellus BlueCross BlueShield - Medical
Buffalo, NY
05.2024 - 05.2025
- Reviewed and verified benefits while processing prior authorization requests for medical procedures and specialty medications to ensure adherence to regulatory standards.
- Evaluated medical necessity of services requested to ensure compliance with established criteria and guidelines while effectively managing provider inquiries.
- Ensured precise documentation of prior authorization activities to support compliance and operational efficiency.
- Coordinated efforts with pharmacy personnel to ensure efficient and timely processing of medication-related prior authorizations.
- Maintained strict confidentiality of sensitive patient data to uphold HIPAA standards throughout prior authorization procedures.
- Developed and delivered training sessions for new team members to ensure proficiency in handling prior authorizations and specialty medication processing requirements.
- Conducted thorough reviews utilizing knowledge of medical terminology and coding systems to ensure accuracy and compliance.
- Monitored adherence to state regulations to ensure effective utilization management practices.
Prior Authorization Technician
Independent Health
Buffalo, NY
12.2023 - 05.2024
- Facilitated communication of changes and trends in insurance policies to team members.
- Secured pre-authorization from insurance carriers for medical services within specified time constraints.
- Assisted in obtaining prior authorizations for patient services. Supported adherence to HIPAA regulations and medical office procedures. Demonstrated understanding of medical terminology and office operations.
- Optimized work rate to align with departmental productivity standards.
- Documented all communications with providers and personnel in standardized formats to ensure consistency.
- Analyzed denial reasons and advocated for patients to secure necessary approvals.
- Cultivated relationships with physician offices and clinics through proactive email outreach and timely phone correspondence.
- Assisted in applying medical terminology, CPT, and ICD codes accurately. Supported departmental processes for data capture within the multidisciplinary team.
- Facilitated professional and respectful communication with provider offices, insurance companies, and patients.
- Facilitated initiatives to enhance employee engagement and customer satisfaction through teamwork promotion.
- Facilitated communication with provider offices and payers. Utilized various systems and tools to obtain and confirm authorization information.
Certified Pharmacy Technician/Prior Authorization
Centene/Fidelis
Buffalo, NY
11.2022 - 08.2023
- Handled incoming questions from providers and policyholders, focusing on pharmacy benefits details.
- Assessed and implemented overrides on medications as required to support healthcare protocols.
- Developed and delivered comprehensive training on administrative procedures and benefits to pharmacy members and healthcare providers.
- Ensured swift resolution of inquiries, maintaining high standards of service.
- Optimized resource utilization to enhance response quality and client satisfaction.
- Managed comprehensive documentation of inquiries and implemented continuous improvement strategies for drug coverage issue resolution.
- Executed patient transfer processes to pharmacists or supervisors for additional evaluation based on identified needs.
NYS Contact Tracer (COVID-19)
Selective Staffing
Buffalo, NY
05.2020 - 11.2022
- Coordinated language translation services to ensure clear communication and engagement with varied cultural communities.
- Executed detailed documentation of case investigation findings to ensure accurate records in centralized databases.
- Analyzed workflows and partnered with team members to improve efficiency in contact tracing program.
- Managed sensitive information with discretion while facilitating access to essential resources and support for affected individuals.
Pharmacy Technician II
Onco360
Buffalo, NY
07.2017 - 05.2020
- Exhibited expertise in comprehending and managing diverse oncology treatment regimens, including drug selection and dosage administration.
- Monitored updates in insurance policy coding regulations and reimbursement processes for oncology services.
- Facilitated collaboration with oncologists, nurses, and healthcare professionals to streamline authorization approval processes.
- Delivered financial counseling to patients regarding oncology treatment responsibilities.
Education
Upper secondary education - undefined
Pharmacy Technician - undefined
Erie Community College
Buffalo, NYSkills
- Long term care
- Pharmacy technician experience
- Time Management
- Typing
- Healthcare management
- Medical Billing
- Hospital experience
- Billing
- Customer service
- Patient Care
- Hospital Experience
- Anatomy knowledge
- Medical records
- Kronos
- Cash Handling
- HIPAA
- Microsoft Word
- Insurance Verification
- Inventory
- Customer Service
- Oncology
- Cash handling
- Contracts
- ICD-10
- Compounding
- VLOOKUP function
- Medical billing
- EMR systems
- Outlook
- Laboratory Experience
- Adobe Acrobat
- Revenue cycle management
- Word
- Order entry
- Order Entry
- EHR systems
- Medical terminology
- Clerical experience
- Compounding Medications
- Pharmacy
- Epic
- Aseptic Technique
- Computer networking
- ICD coding
- Workday
- Data entry
- Microsoft Office
- Laboratory experience
- Vital signs
Certification
- PTCB Certification
- CPR Certification
- Pharmacy Technician Certification
- Driver's License
- Pharmacy Technician License
- BLS Certification
- Registered Pharmacy Technician
- First Aid Certification
Languages
Bilingual
Timeline
Senior Associate, RX Specialist
Ametros Financial
06.2025 - Current
Specialty/Oncology Prior Authorization Technician
Kelly Services/Excellus BlueCross BlueShield - Medical
05.2024 - 05.2025
Prior Authorization Technician
Independent Health
12.2023 - 05.2024
Certified Pharmacy Technician/Prior Authorization
Centene/Fidelis
11.2022 - 08.2023
NYS Contact Tracer (COVID-19)
Selective Staffing
05.2020 - 11.2022
Pharmacy Technician II
Onco360
07.2017 - 05.2020
Upper secondary education - undefined
Pharmacy Technician - undefined
Erie Community College