Michelle Marshall
Port St. Lucie,,Florida
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
10
10
years of professional experience
Work History
Clinical Configuration & Benefits Analyst
Cognizant Technologies (Contract)
Port St. Lucie , FL
2021.10 - 2022.08
- Data mining large data sets and critically analyzing for trends and accuracy.
- Made clinical changes to Medicaid plans for each state as requested by the client.
- Utilized EZ query to pull relevant data for the C.I matrix document creation.
- Developed and maintain job aids, policies and process documents
- Utilized V-look up to find relevant information from different excel workbooks.
- Delivered targeted advise on issues such as applicable employment regulations, compensation strategies and internal systems to help companies update antiquated or ineffective approaches.
- Used Problem-solving skills to resolve any coding edits by researching policies and specific work instructions.
- Build and coded new benefit plan designs into the corporation's claims processing system, called RxClaim
- Reviewed and analyzed client's requests, for benefits coding.
- Analyzed client's requests, and installed adjudication-related drug lists (eg formulary, clinical edits, plan coverage, etc) in Rxclaim.
- Collaborate regularly with team to audit, review and verify drug list coding and testing while utilizing various tools.
- Support urgent issues not limited to research and analysis of drug lists setup.
- Utilized salesforce to maintain and track work assignments.
- Other responsibilities as required.
Pharmacy Technician /Benefits Analyst
Remed Pharmacy
Port Saint Lucie , FL
2016.06 - 2021.08
- Advised patients on medication side effects and contraindications and explained proper administration.
- Verified patient data and billing information to discover and resolve erroneous bills due to system errors.
- Processed over 250 prescriptions per day in busy pharmacy achieving decreased customer wait times and maintaining excellent customer satisfaction.
- Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Explored options with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
- Assisted patients in minimizing medical expenses by recommending generic alternative prescription medications.
- Counted and labeled prescriptions with correct item and quantity.
Pharmacy Technician, Customer Service
Robalo Pharmacy
West Palm Beach , FL
2012.02 - 2016.06
- Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
- Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Counted, measured, and compounded medications following standard procedures.
- Restocked pharmacy shelves with consistently to make sure patients were serviced the same day the prescriptions were needed.
- Solved customer problems in-person, electronically or over telephone by providing assistance with placing orders, navigating systems and locating items.
Education
Associate of Science - Business Administration
Indian River State College
Ft. Pierce, FL05.2019
Certification - Pharmacy Technology
MCI Institute of Technology
West Palm Beach, FL01.2012
Skills
- Medicare and Medicaid process
- Database Management
- RxClaim/AS400
- Salesforce
- Completing regulatory documents
- Protocol adherence
- Microsoft Excel
- Analytical and Critical Thinking
- Teamwork and Collaboration
- Excellent Communication
- Benefits Coding
- Data Entry
- EZ Query
Timeline
Clinical Configuration & Benefits Analyst
Cognizant Technologies (Contract)
2021.10 - 2022.08
Pharmacy Technician /Benefits Analyst
Remed Pharmacy
2016.06 - 2021.08
Pharmacy Technician, Customer Service
Robalo Pharmacy
2012.02 - 2016.06
Associate of Science - Business Administration
Indian River State College
Certification - Pharmacy Technology
MCI Institute of Technology
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