Melissa Murr
Trenton,OH
Summary
Results-driven Quality Review and Audit Analyst with expertise in internal auditing and quality assurance. Known for meticulous attention to detail and effective communication, contributing to regulatory compliance and enhanced internal controls.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Quality Review and Audit Analyst
CIGNA
07.2022 - 09.2025
- Reviewed internal policies to ensure alignment with regulatory standards.
- Collaborated with cross-functional teams to gather necessary audit information.
- Evaluated internal control systems to ensure efficient use of resources.
- Assessed internal controls, identified deficiencies, and recommended corrective actions.
Prior Authorization Senior Representative
Express Scripts
Fairfield, OH
12.2013 - 07.2022
- Managed customer inquiries regarding prescription medications and insurance coverage.
- Collaborated with healthcare providers to resolve patient medication issues.
- Conducted training sessions for new team members on operational procedures.
- Oversaw claim processing to ensure compliance with regulatory standards.
- Developed standard operating procedures for efficient workflow management.
- Mentored junior representatives on best practices in customer service interactions.
- Trained new hires on customer service processes and protocols.
- Mentored junior staff members in providing excellent customer service.
- Coordinated special projects within the department as assigned by management.
Education
Pharmacy Technician Diploma - Pharmacy Technician
Remington College
Little Rock, AR11-2004
Skills
- Internal auditing
- Quality assurance
- Claim processing
- Policy development
- Customer engagement
- Attention to detail
- Effective communication
- Problem solving
- Mentoring team members
- Training facilitation
- Microsoft Excel
- Coaching and mentoring
- Innovation and creativity
- Issue resolution
- Project management
- SOP adherence
- Team collaboration
- Multitasking and organization
- Continuing education
- Critical thinking
- Clear communication
- Time management
- Prescription processing
- Inventory management
- Drug storage procedures
- Proper labeling procedures
- Medicare and medicaid process
- Drug classification
- Prescription interpretation
- HIPAA compliance
- Compounding techniques
- Pharmaceutical calculations
Certification
- Certified Pharmacy Technician for 21 years
Timeline
Quality Review and Audit Analyst
CIGNA
07.2022 - 09.2025
Prior Authorization Senior Representative
Express Scripts
12.2013 - 07.2022
Pharmacy Technician Diploma - Pharmacy Technician
Remington College
Similar Profiles
Heidi SchochHeidi Schoch
Appeals Coordinator at CignaAppeals Coordinator at Cigna
Kilah CurtisKilah Curtis
Customer Service Representative at CignaCustomer Service Representative at Cigna
Keonta JohnsonKeonta Johnson
Claim Healthcare Specialists at CignaClaim Healthcare Specialists at Cigna
Jennifer SmithJennifer Smith
Eligibility Representative – Specialty Pharmacy Division at CignaEligibility Representative – Specialty Pharmacy Division at Cigna
Patrick TallonPatrick Tallon
Furniture Mover at Clark and Sons MovingFurniture Mover at Clark and Sons Moving