Megan Jones
LA PORTE,TX
Summary
Dynamic Pharmacy Intake Specialist with proven expertise at Blue Cross Blue Shield NC in prior authorization and formulary verification. Skilled in effective communication and problem-solving, I enhance patient satisfaction through compassionate support and meticulous documentation, driving operational efficiency and ensuring compliance in fast-paced environments.
Overview
1
1
Certification
8
8
years of professional experience
Work History
Pharmacy Intake Specialist
Blue Cross Blue Shield NC
06.2025 - Current
- Answer inbound calls from members and providers’ offices to either find out formulary drugs or to initiate a prior authorization
- Assisted callers with questions regarding authorizations to ensure clarity and understanding.
- Documented each interaction with accurate notes in patient profiles to maintain comprehensive records.
- Multitasking between multiple windows to research and provide correct information to callers
- Followed up with callers to resolve troubleshooting issues after consulting with leadership.
Pharmacy Intake Specialist
Pyramid Consulting
11.2024 - 06.2025
- Assisted callers with questions regarding authorizations, ensuring clarity and support throughout the process.
- Answer inbound calls from members and providers' offices to either find out formulary drugs or how to initiate a prior authorization
- Multitasking between multiple windows to research and provide correct information to callers
- Followed up with callers to resolve troubleshooting issues after consulting with leadership.
- Documented each interaction with accurate notes in patient profiles to maintain comprehensive records.
Lead Pharmacy Technician
TC SCRIPT
09.2023 - 04.2024
- Coordinated medication deliveries to patients' homes or doctor's offices, ensuring timely access to prescriptions.
- Managed team productivity and workflow, enhancing service delivery and operational effectiveness.
- Outbound calls to patients and doctor offices regarding patient medications
- Answer inbound calls from patients or providers' offices checking on status of current or past orders
- Assist in coaching/ retraining employees
- Assisted in special projects through coordination and support, contributing to successful project outcomes.
- Reviewed data to confirm order accuracy and compliance with drug company regulations.
Pharmacy Technician
Alliance Healthcare Solutions (TC SCRIPT)
03.2023 - 09.2023
- Entered patient profile information, including address, date of birth, allergies, and current medications, ensuring accurate records
- Coordinated delivery of patient medications to home addresses or doctor offices, facilitating timely access to prescriptions
- Answer inbound calls from patients or providers' offices checking on status of current or past orders
- Conducted outbound calls to patients and doctor offices to confirm medication details and address inquiries
Sr Clinical Pharmacy Technician
Aetna
09.2018 - 03.2023
- Answered inbound calls from members and provider offices to verify formulary drugs or start prior authorization requests.
- Notified members of authorization status through outbound calls to provide clear updates and support satisfaction.
- Processed incoming appeals for timely review and smooth case handling.
- Entered medication overrides for approved prescriptions.
- Reviewed approval and denial letter reports for accuracy through quality control checks.
- Prepared incoming faxes and ePA requests in queues for processing.
- Trained new employees on company procedures and system use.
- Supported leadership with special projects to improve team efficiency.
Sr Clinical Pharmacy Technician
HealthCare Recruiting/ Aetna
04.2018 - 09.2018
- Answered inbound calls from members and provider offices to verify formulary drugs and initiate prior authorizations
- Made outbound calls to members to inform them of authorization decisions
- Processed incoming faxes and expedited EPAs to ensure timely handling
- Entered overrides for approved medications
Education
High School Diploma -
El Dorado High School
Chandler, AZ06-2011
Skills
- Prior authorization and formulary verification
- Patient documentation
- Quality control
- Workflow management
- Client relationship management
- Medical terminology
- Effective communication
- Compassionate communication
- Problem solving
- Time management
- Staff onboarding
- Team collaboration
- Medical terminology
Certification
PCTB License: 10097938, Texas State Board of Pharmacy License: #372871
Timeline
Pharmacy Intake Specialist
Blue Cross Blue Shield NC
06.2025 - Current
Pharmacy Intake Specialist
Pyramid Consulting
11.2024 - 06.2025
Lead Pharmacy Technician
TC SCRIPT
09.2023 - 04.2024
Pharmacy Technician
Alliance Healthcare Solutions (TC SCRIPT)
03.2023 - 09.2023
Sr Clinical Pharmacy Technician
Aetna
09.2018 - 03.2023
Sr Clinical Pharmacy Technician
HealthCare Recruiting/ Aetna
04.2018 - 09.2018
High School Diploma -
El Dorado High School