Michelle Anthony

• Processed Authorizations and benefit exceptions for Ohio State medicaid clients
• Tracked referral submission during facilitation of prior authorization issuance.
• Responded to inquiries from healthcare providers regarding prior authorization requests.
• Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.
• Evaluated clinical criteria for approval or denial of services requiring pre-authorization.

• Clinic Support Representative for front-line support for clinic customers and ensure that customer inquiries are addressed in timely manner
• CSR also provide product information, answer product and order related questions, assist in prescription clarification, and escalate inquires as needed
• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.

Responsible for assisting pharmacist in carrying out their duties using pharmacy system to get information about the patient and drug and process prescriptions

• Provide fast, courteous, and efficient customer service to customers.
• Resolved customer complaints professionally, turning negative experiences into opportunities for improvement.
• Trained new employees on store procedures and protocols, fostering positive work culture that prioritized teamwork and collaboration.
• Efficiently managed multiple tasks simultaneously, balancing needs of customers with store responsibilities effectively.

• Kept informed of changes in insurance regulations and policies, ensuring that all verification procedures remained compliant and up to date.
• Improved patient satisfaction rates by providing clear explanations of benefits, coverage, and billing procedures.
• Expedited claim approvals with thorough pre-authorization submissions and diligent followups.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Updated patient records with accurate, current insurance policy information.
• Managed high-volume insurance verifications within pressured timeframes for productive medical operations.

• Utilized clinical knowledge to identify potential drug interactions or contraindications during reconciliation process, ensuring optimal patient outcomes.
• Strengthened communication between patients, ER physician, and healthcare providers through regular updates on medication changes and adjustments.
• Educated patients on important aspects of their medications such as administration techniques or storage considerations while reinforcing adherence to therapy.
• Remained up-to-date on latest best practices and guidelines related to medication reconciliation through ongoing professional development opportunities.
• Contributed to positive patient experience by addressing questions and concerns about medications in compassionate manner.
• Enhanced medication management for patients by diligently updating electronic medical records with accurate information.
• Promoted patient adherence to medication regimens by providing clear instructions on dosage, frequency, side effects, and potential interactions.

• Expedited prescription fulfillment through proficient use of pharmacy software systems, resulting in reduced wait times for customers.
• Facilitated seamless communication between patients, healthcare providers, and insurance companies to expedite prescription processing.
• Developed strong relationships with patients through empathetic listening and tailored guidance on medication usage directions or side effects prevention tips.
• Improved patient safety by ensuring accurate medication dispensing and proper dosage calculations.

Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.

• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Conducted regular inventory audits to identify discrepancies and reduce instances of stockouts or expired medications on pharmacy shelves.
• Supported development of junior pharmacy technicians through continuous training, mentorship, and performance evaluations.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
• Educated patients on available medication therapy management services offered at pharmacy.