Myia Malone
Fort Worth,TX
Summary
Results-oriented and highly organized Pharmacy Care Coordinator with a background in healthcare administration and pharmaceutical services. Proven ability to streamline pharmacy operations, enhance patient care, and ensure regulatory compliance. Adept at facilitating seamless communication between healthcare professionals, patients, and insurance providers to optimize medication therapy management. Strong interpersonal and problem-solving skills, committed to delivering exceptional patient service. Seeking to leverage expertise in medication coordination, insurance verification, and healthcare administration to contribute to a dynamic healthcare team.
Overview
7
7
years of professional experience
Work History
Prior Authorization Index Specialist
Equity Staffing - UHC
06.2024 - 03.2025
- • verifying insurance coverage, processing claims, or handling prior authorizations.
- • Obtain pre-authorization from insurance carriers for medical services within a designated time frame.
- • Follow up and secure prior-authorizations prior to service appointments. Demonstrate proficiency in medical terminology and general medical office procedures, including HIPAA regulations.
- • Maintain a productive work rate suitable for the department.
- • Record all communication with providers and personnel in standardized documentation with the proper format.
- • Review denial reasons and advocate for patients while obtaining approval/denial letters, informing the office of results, and providing appeal services.
- • Build relationships with physician offices and clinics by initiating contact via email, answering phone/email correspondence promptly, and responding within one business day.
PHARMACY COORDINATOR
REMX
10.2022 - 04.2024
- Coordinated and managed pharmacy operations to ensure the efficient and accurate dispensing of medications.
- Oversaw inventory management, including ordering, receiving, and maintaining adequate stock levels of pharmaceuticals and supplies.
- Implemented and maintained medication therapy management programs, monitoring patient adherence, and providing education on proper medication usage.
- Facilitated communication between healthcare professionals, ensuring seamless collaboration in patient care and promoting a patient-centric approach.
BENEFITS VERIFICATION CLERK
CVS PHARMACY
09.2021 - 08.2022
- Conducted regular audits to ensure the accuracy and completeness of insurance data, proactively identifying and rectifying any discrepancies.
- Coordinated the benefits verification process to secure accurate and up-to-date information on patients' insurance plan.
- Developed and maintained a systematic process for benefits verification, improving efficiency and reducing delays in patient care.
- Responsible for verifying and updating patient insurance information in electronic health records to facilitate accurate billing and claims processing.
CUSTOMER CARE SPECIALIST
WALGREENS PRIME
06.2019 - 04.2020
- Provided exceptional customer service to Walgreens Prime customers through various communication channels, including phone, email, and chat.
- Coordinated with pharmacy and healthcare teams to ensure accurate and timely dispensing of medications, while prioritizing customer satisfaction.
- Documented customer interactions, ensuring accurate and detailed records for follow-up and continuous improvement.
- Collaborated with healthcare providers and insurance companies to obtain prior authorizations and resolve any issues affecting prescription fulfillment.
CLAIMS ADJUSTER
E A RENFROE & COMPANY
10.2017 - 05.2019
- Conducted investigations into the circumstances of accidents, collaborating with law enforcement, medical professionals, and accident reconstruction specialists.
- Communicated with policyholders, claimants, and legal representatives to facilitate the resolution of insurance claims.
- Negotiated settlements with claimants, attorneys, and other parties, aiming to achieve fair and cost-effective resolutions.
- Investigated and assessed insurance claims to determine coverage, liability, and potential settlement amounts.
- Directed claims negotiations within allowable limit and supported successful litigations for advanced issues.
Education
Associate of Arts - Pharmaceutical Medicine
CCI TRAINING
Arlington, Tx04.2022
High School Diploma -
Sam Houston High School
Arlington, TxSkills
- Medication Management
- Insurance Verification
- Healthcare Compliance
- Problem Solving
- Empathy
- Multitasking
- Patient counseling
- Medical Terminology
- Patient Education
- Prior Authorization
- Dosage calculations
- Building rapport
- Time Management
- Decision-making
- Patient-focused service
- Record-keeping
Timeline
Prior Authorization Index Specialist
Equity Staffing - UHC
06.2024 - 03.2025
PHARMACY COORDINATOR
REMX
10.2022 - 04.2024
BENEFITS VERIFICATION CLERK
CVS PHARMACY
09.2021 - 08.2022
CUSTOMER CARE SPECIALIST
WALGREENS PRIME
06.2019 - 04.2020
CLAIMS ADJUSTER
E A RENFROE & COMPANY
10.2017 - 05.2019
High School Diploma -
Sam Houston High School
Associate of Arts - Pharmaceutical Medicine
CCI TRAINING
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