Matiya Cromartie
Summary
Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Clinical Pharmacy Technician II
Magellan Health/Prime Therapeutics
2020.10 - Current
- Determines appropriateness for medications
- Communicates decision to physicians, physician’s office staff, medical management staff and/or pharmacists
- Research, resolves, and documents prior authorization outcomes in pharmacy system
- Resolves customer administrative concerns as first line of contact - this may include claim resolutions and other expressions of dissatisfaction
- Assists efforts to continuously improve by assuming responsibility for identifying and bringing to attention of responsible entities operations problems and/or inefficiencies
- Assists in mentoring and training of new staff
- Monitors telephone system to ensure adequate staffing to maintain client services levels.
- Provided support during medication-related emergencies, applying critical thinking skills and clinical expertise to mitigate potential risks.
- Conducted thorough medication reviews to identify and resolve discrepancies, preventing potential errors.
Clinical Pharmacy Technician I
Magellan Health Services
2015.05 - 2020.10
- Verified insurance coverage on controlled substance prescriptions prior to filling them out
- Resolved customer service issues regarding prescription refills or discrepancies between ordered drugs and dispensed drugs
- Teamed with peers, technicians, and pharmacists to prioritize and complete orders
- Assisted customers by answering questions, locating items, or referring to pharmacist for medication information.
- Coordinated verification of more than 100 daily prescriptions in high-volume Pharmacy Benefit Management Call Center environment.
Clinical Pharmacy Technician Medicare Part D
Aetna
2013.03 - 2015.05
- Evaluates and approves prior authorization for insurance members
- Assist pharmacies with claim adjudication, receives, reviews, and processes all forms associated with insurance/benefit claims
- Escalate member request for prescription medication that require pharmacist approvals
- Obtain clinical information through partnership with medical personnel for member approvals based upon clinical criteria set by CMS guidelines
- Conducts quality reviews and claim adjudication audits.
- Coordinated verification and filling of more than 100 daily prescriptions in high-volume Pharmacy Benefit Call Center environment.
Triage LTC Pharmacy Technician
Williamson's Pharmacy
2012.11 - 2013.03
- Open orders as needed, verify eligibility, proof and input prescriptions while maintaining productivity and quality standards
- Prepare audit sheets and provide feedback to manager
- Forward incomplete or rejected scripts to appropriate department for resolution and track status in system
- Initiate and document correspondence and follow up in system
- Answer incoming calls promptly and provide high standard of customer service to client based upon priority assignments
- Performed weekly follow ups with clients for medication/STAT box needs.
- Coordinated verification and filling of more than 95 daily prescriptions in high-volume Long Term Care pharmacy environment.
Education
Pharmacy Technology
VIRGINIA COLLEGE
10.2012
High School Diploma -
Hopewell High School
Hopewell, VA06.2000
Skills
- Pharmacy
- Insurance Billing
- Regulatory Compliance
- Billing Support
- Insurance Verification
- EXCEL
- MSWORD
- Problem-Solving Skills
- Staff Development
- Team Collaboration
- HIPAA
- Interpreting Orders
- Resolving Customer Issues
- Medication Reconciliation
- Drug Classification Knowledge
- Pharmacy Software Proficiency
Certification
- Pharmacy Technician Certification Board, 04/30/2025
- Georgia State Board of Pharmacy, 06/30/2025
Timeline
Clinical Pharmacy Technician II
Magellan Health/Prime Therapeutics
2020.10 - Current
Clinical Pharmacy Technician I
Magellan Health Services
2015.05 - 2020.10
Clinical Pharmacy Technician Medicare Part D
Aetna
2013.03 - 2015.05
Triage LTC Pharmacy Technician
Williamson's Pharmacy
2012.11 - 2013.03
Pharmacy Technology
VIRGINIA COLLEGE
High School Diploma -
Hopewell High School
- Pharmacy Technician Certification Board, 04/30/2025
- Georgia State Board of Pharmacy, 06/30/2025
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