Melvin Mendez
White Plains,NY
Summary
Board certified Pharmacy Technician (PTCB) with 10 years of experience in pharmacy benefits management and retail. Proven track record of enhancing accuracy and efficiency in pharmacy operations. Skilled in adapting to new technologies and information systems to improve service delivery.
Overview
6
6
years of professional experience
Work History
Prior Authorization Coordinator/CVS Contract
Mindlance Health
Remote, NY
12.2022 - 11.2024
- Answered 80+ incoming calls and faxes from providers to initiate prior authorizations
- Reviewed clinical documentation and Icd 10 codes for pa, ran mock claim and forward to medical clinician for approval.
- Clarified inquiries with patients and providers to update patient account information.
- Send approval information to patients, providers and dispensing pharmacies.
Pharmacy Coordinator-Prior Authorizations
SNI Companies
Remote, FL
05.2019 - 02.2022
- Act as Medicare Part D liaison between pharmacies, medical centers, clinics, and primary care physicians.
- Answer incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers.
- Maintain patient records with strong attention to detail and confidentiality per CMS, HIPPA, federal, state and local guidelines for Part D clients.
- Advise coverage determination and process prior authorization requests and appeals.
- Place outbound calls to patients to advise approval and set up delivery for the medications; while communicating in a courteous and respectful manner.
Certified Pharmacy Technician
Soliant Healthcare
Miami, FL
06.2018 - 04.2019
- Verified and filled over 150 prescriptions per day in busy clinic pharmacy setting.
- Prepared pricing and instruction labels for placement on prescriptions.
- Educated patients on prescription instructions and answered questions regarding drug side effects.
- Efficiently processed cash register transactions for new and refilled prescription orders.
Education
National Certified Pharmacy Technician
PTCB-CpHT
04.2018
Registered Pharmacy Technician
RPT
Florida12.2015
High School Diploma -
Brentwood High School
Brentwood, NY06.1997
Skills
- Detail-Oriented
- Customer Service
- HIPAA Compliance
- Collaboration and Teamwork
- Pharmacy Policies and Procedures
- ICD 10 coding
- Prior authorization
Languages
Spanish
Professional
Timeline
Prior Authorization Coordinator/CVS Contract
Mindlance Health
12.2022 - 11.2024
Pharmacy Coordinator-Prior Authorizations
SNI Companies
05.2019 - 02.2022
Certified Pharmacy Technician
Soliant Healthcare
06.2018 - 04.2019
National Certified Pharmacy Technician
PTCB-CpHT
Registered Pharmacy Technician
RPT
High School Diploma -
Brentwood High School
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