NICOLE HOUGHTON
Pamplin,VA
Summary
Healthcare professional supporting medication access through prior authorizations, reimbursement, insurance verification, and patient assistance programs. Coordinates with providers and patients to gather documentation, resolve coverage issues, and keep records accurate for timely pharmacy and medical office operations.
Overview
1
1
Certification
15
15
years of professional experience
Work History
Reimbursement Specialist
VCU Health System
Richmond, VA
09.2022 - Current
- Facilitated reimbursement and revenue collection for high-cost medications requiring prior authorization, ensuring patient access.
- Initiate, process, and follow up on prior authorization requests to facilitate medication access.
- Conduct insurance benefits investigations to determine medication coverage and patient financial responsibility.
- Assist patients with applications for manufacturer-sponsored and other eligible patient assistance programs.
- Assisted patients in enrolling in copay assistance programs, minimizing out-of-pocket medication costs.
- Coordinated with physicians, nurses, and other healthcare professionals to gather necessary clinical documentation and complete applications.
- Communicate with patients and healthcare team members regarding documentation and authorization requirements.
Pharmacy Technician
Walgreens
Farmville, VA
08.2019 - 12.2025
- Facilitated prescription processing, label preparation, and medication filling for pharmacist review and approval.
- Verified patient demographic and insurance information to ensure accurate and timely prescription processing.
- Processed customer transactions and assisted with prescription orders.
- Managed telephone inquiries, delivering courteous customer service and resolving patient concerns.
- Assisted with pharmacy inventory management, supply organization, and medication storage.
- Completed administrative and clerical duties to support efficient daily pharmacy operations.
Pharmacy Technician II
Centra Health, Inc.
Farmville, VA
05.2021 - 09.2022
- Prepared intravenous (IV) solutions following pharmacy procedures and safety protocols to ensure patient safety.
- Prepackaged bulk medications into unit-dose formats to streamline medication distribution to hospital units.
- Managed pharmacy inventory by monitoring stock levels and rotating medications to maintain optimal supply and prevent shortages.
- Prepared and replenished emergency medication boxes and code trays for distribution to patient care units.
- Retrieved and distributed patient medications to hospital floors.
- Responded to medication-related questions and coordinated with nursing and medical staff within the scope of pharmacy technician responsibilities.
Medical Office Associate II
Centra Health, Inc.
Farmville, VA
07.2018 - 05.2021
- Registered patients and scheduled appointments, enhancing workflow and supporting timely patient care.
- Verified and updated patient demographic and insurance information to ensure accurate records and facilitate billing processes.
- Entered service charges and collected payments due at the time of service.
- Answered incoming telephone calls, directing patients and inquiries to appropriate departments for prompt resolution.
- Provided administrative support while maintaining accurate patient information.
Server
IHOP
Lynchburg, VA
05.2019 - 02.2020
- Welcomed guests to IHOP with a friendly demeanor. and presented breakfast menu recommendations.
- Took food and beverage orders accurately using POS system.
- Delivered entrées, coffee, and refills to guest tables.
- Provided customer service, greeted guests, processed takeout orders, ensured accurate and timely food and beverage service.
Shift Manager
Pizza Hut
Appomattox, VA
01.2019 - 05.2019
- Managed team performance during busy shifts to maintain high customer satisfaction.
- Directed daily restaurant operations, supported team members, ensured compliance with company procedures, and managed closing, cash reconciliation, and bank deposit processes.
- Trained crew on customer service, food preparation, and restaurant standards.
- Monitored order accuracy through point-of-sale systems and kitchen tickets.
Youth Care Professional
Gateway Longview
Buffalo, NY
12.2016 - 07.2018
- Monitored safety and well-being of youth in residential care, ensuring a secure environment for personal growth.
- Built therapeutic relationships through positive role modeling and supportive interactions.
- Responded to individual needs, fostering healthy interpersonal relationships and promoting emotional development.
- Collaborated with treatment team members to support individualized care plans.
- Planned and supervised activities to enhance social, vocational, and cultural development, enriching youth experiences.
Front-End Associate
DICK'S Sporting Goods
Buffalo, NY
10.2016 - 07.2018
- Processed customer purchases at DICK'S Sporting Goods registers
- Handled returns, exchanges, and price checks at front end
- Processed customer transactions and promoted company programs to enhance checkout experience.
- Provided friendly greetings to customers entering store and answered product questions
Day Bar Manager
Tony Romes Globe Hotel And Restaurant
East Aurora, NY
04.2012 - 02.2016
- Assisted in bar operations at Tony Romes, ensuring efficient service and customer satisfaction. and maintained beverage service standards.
- Trained bartenders on Tony Romes cocktail recipes and guest service practices.
- Placed liquor, beer, and wine orders for Tony Romes inventory.
- Supported cash drawer balancing and deposit preparation, handled takeout orders, assisted customers, and kept restaurant service moving promptly.
Customer Service Representative
Sunoco
Elma, NY
08.2013 - 03.2015
- Responded to Sunoco customer inquiries by phone.
- Processed service requests in Sunoco customer support systems.
- Assisted customers with inquiries and transactions, processed cash register transactions efficiently, prepared food items for sale, and maintained organized merchandise inventory.
Education
New York State Regents Diploma -
Iroquois High School
Elma, NY06-2012
Skills
- Prior Authorization Processing
- Reimbursement authorizations
- Insurance verification
- Patient Assistance Programs
- Copay Assistance Programs
- Healthcare documentation
- Patient Registration and Scheduling
- Patient support
- Pharmacy operations
- Medication Inventory Management
- Interdepartmental Communication
- Cash Handling and Administrative Support
Certification
- Pharmacy Technician Certificate / Virginia State Licensing 2020
- Pharmacy Technician Board Certificate / National Certification 2020
COMMUNITY INVOLVEMENT & VOLUNTEER EXPERIENCE
- Private-Duty Caregiver, New York, 2012-04, 2018-07, Assisted individuals with activities of daily living, including meals, toileting, ambulation, and transfers., Obtained vital signs, supported turning and positioning, and completed basic dressing changes according to the care plan., Assisted with medication administration as assigned and in accordance with applicable care instructions.
- Ladies of Charity, Buffalo, NY, 2006-06, 2017, Organized and distributed donated school supplies and accessories to families in need., Prepared and delivered gifts and supplies to elderly community members., Participated in fundraising activities, including charity fashion shows.
- Fish of East Aurora, East Aurora, NY, 2007-10, 2018, Collected, sorted, and organized food donations for community food pantry distribution., Picked up food donations from local grocery stores and the Western New York Food Bank.
- Immaculate Conception Church, Youth Leader, East Aurora, NY, 2009-02, 2013, Helped establish and develop junior and senior high youth ministry programs., Participated in planning meetings and organized youth group activities and events., Supported activities that encouraged fellowship, community participation, and spiritual development., Participated in youth retreat planning and leadership teams.
Timeline
Reimbursement Specialist
VCU Health System
09.2022 - Current
Pharmacy Technician II
Centra Health, Inc.
05.2021 - 09.2022
Pharmacy Technician
Walgreens
08.2019 - 12.2025
Server
IHOP
05.2019 - 02.2020
Shift Manager
Pizza Hut
01.2019 - 05.2019
Medical Office Associate II
Centra Health, Inc.
07.2018 - 05.2021
Youth Care Professional
Gateway Longview
12.2016 - 07.2018
Front-End Associate
DICK'S Sporting Goods
10.2016 - 07.2018
Customer Service Representative
Sunoco
08.2013 - 03.2015
Day Bar Manager
Tony Romes Globe Hotel And Restaurant
04.2012 - 02.2016
New York State Regents Diploma -
Iroquois High School