Perla Ortega
Tolleson
Summary
Ambitious, Board-Certified Pharmacy Technician looking to bring several years of experience to a growing team in this challenging and rewarding field. Recent experience in a fast-paced pharmacy call center environment. Quickly and effectively understands, documents, and resolves member concerns, driving satisfaction while meeting business objectives. Focusing on building relationships with members and promoting teamwork within pharmacy settings.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Finance Mail Operations Pharmacy Technician II
Humana
Phoenix, Arizona
01.2022 - Current
- Processed prescriptions accurately for various medications and patient needs.
- Review and determine eligibility for medical insurance coverage and other benefit plans.
- Process claims and ensure that accurate information is provided to members.
- Received payment from customers and processed credit card transactions when necessary.
- Responded promptly to member inquiries about coverage options, claims status, and other related topics.
- Reviewed policy documents to ensure compliance with regulatory standards.
- Conducted thorough investigations into disputed claims for resolution.
- Verified documents to ensure accuracy of information provided by members.
- Assisted members with inquiries regarding Medicare benefits and coverage options.
- Maintained accurate records of all claim activities in accordance with company policies.
- Assessed medical records for coverage eligibility and benefit accuracy.
- Processed requests for payments from external vendors or other entities related to grant programs.
- Collaborated with other healthcare professionals to ensure optimal patient care.
- Provided exceptional customer service, addressing patient questions and concerns with empathy.
- Communicated effectively with providers, insurance agencies, and various departments within the organization to resolve member issues quickly and efficiently.
- Utilized CRM software to track customer interactions and improve service delivery.
- Assisted in training new staff in the Finance department on order processing procedures.
- Other duties as assigned.
Administrative Assistant/Dispatcher
SHAMROCK FOODS COMPANY
Phoenix
02.2011 - 04.2020
- Compiled and analyzed data utilizing spreadsheets or other database software.
- Directed customer communication to appropriate department personnel and offered information to resolve inquiries, boosting customer satisfaction.
- Resolved fuel island issues quickly and escalated critical problems immediately to office manager.
- Coordinated project materials by managing physical and digital files, monitoring spreadsheets, and updating reports.
- Kept tracking system of Fuel Master information for the tracking of all fuel transactions for the different divisions. (AZ, CO, NM, CA, ID)
- Analyzed invoice and expense reports, identified variances and researched issues to correct problems and maintain financial compliance.
- Eliminated inaccuracies in accounts payable payments by verifying information prior to generating checks and electronic payment transfers.
- Worked closely with department personnel to produce accurate and timely bills.
- Kept detailed and updated records of calls in physical and electronic databases.
- Coordinate with drivers and warehouse management team to ensure dispatch on time.
- Directs activities of drivers by available communication methods.
- Communicate with all necessary departments with regards to daily driver routes.
- Assure compliance with all safety procedures, company policies and DOT laws.
- Orders and maintains supplies and arranges for equipment maintenance.
- Maintaining files and records so they remain updated and easily accessible.
- Assist in office management and organization procedures.
- Assist in making travel arrangements and booking venues for conferences and events.
- Other duties as assigned
Member Service Representative II
CREDIT UNION WEST
Phoenix
02.2006 - 02.2011
- Cashed checks and disbursed monies after verifying signatures, endorsements, and customer account balance.
- Collected loan payments and placed holds on accounts for uncollected funds, according to organizational procedures.
- Posted night and mail deposits, payments and requests received in mail daily.
- Adhered to strict guidelines regarding financial and customer data to avoid breaches and information misuse.
- Conducted special service and account transactions for customers, including ordering checks and placing stop payment orders.
- Processes cash advances, travelers' checks, cashiers' checks, money orders, bank-to-bank wires, and Western Union wires.
- Receive and process share deposits, loan payments, cash, and check share withdrawals.
- Opening, maintaining, and closing of all account types.
- Cross-selling the Credit Union's products and services.
- Balance daily transactions and verifies cash totals.
- Investigates and resolves out-of-balance conditions.
- Other duties as assigned.
Education
PHARMACY TECHNICIAN CLOCK-HOUR PROGRAM -
Gateway Community College
Phoenix, AZ09.2021
HIGH SCHOOL DIPLOMA -
Camelback High School
Phoenix, AZ05.2007
Skills
- Effective communication skills
- Claims processing
- Proficient in PC and all Microsoft Office products
- FDA compliance and regulations
- Critical thinking skills
- 10-key proficiency
- Verifying prescription claims and orders
- Pharmacy operations
- Recordkeeping and documentation
- Meticulous
- Insurance terminology
- Multitasking Abilities
- Verbal and written communication
- Problem solving
- Data entry accuracy
- Answering and routing calls
- Supporting pharmacy operations
- Resolving customer issues
- CRM software utilization
- Insurance eligibility verification
- Medicare compliance
- Policy review
Languages
Spanish, Native/Bilingual
Certification
- Certified Pharmacy Technician (CPhT) - PTCB
Languages
Spanish
Native/ Bilingual
Timeline
Finance Mail Operations Pharmacy Technician II
Humana
01.2022 - Current
Administrative Assistant/Dispatcher
SHAMROCK FOODS COMPANY
02.2011 - 04.2020
Member Service Representative II
CREDIT UNION WEST
02.2006 - 02.2011
PHARMACY TECHNICIAN CLOCK-HOUR PROGRAM -
Gateway Community College
HIGH SCHOOL DIPLOMA -
Camelback High School