Phylesha Edmond
Staten Island
Summary
Detail-oriented Pharmacy help desk specialist with over 20 years of experience in Customer service and a few years in the healthcare department managing insurance authorizations and ensuring compliance with healthcare regulations. I have a track record of effectively verifying patient eligibility, processing prior authorization requests, and collaborating with healthcare providers to secure necessary approvals. Skilled in utilizing various insurance software systems and maintaining accurate documentation while adhering to HIPAA guidelines. Strong communication and organizational skills, dedicated to enhancing patient care through efficient authorization processes and exceptional customer service. Seeking to leverage my exceptional customer service and claims management skills to enhance pharmacy operations, customer satisfaction, and extensive knowledge of Prior Authorization processes and commitment to exceptional service at this company.
Overview
15
15
years of professional experience
Work History
Pharmacy Help Desk-Temporary Remote Position
Results-CX
06.2020 - 06.2022
- Maintained excellent customer service for all in-bound calls from medical providers and pharmacies requesting prior authorizations for prescription processing
- Provided superior customer service through phone/fax management skills, computer documentation of codes and clinical information for claims
- Resolved claims disputes, requests for clarification, and appeals in an efficient and timely manner Enhanced customer satisfaction by providing top-notch pharmaceutical advice and addressing concerns promptly
- Reduced wait times with accurate and efficient prescription processing, ensuring a seamless customer experience
- Supported team members in achieving company goals by consistently meeting individual performance targets
- Assisted customers in navigating insurance claims, resulting in fewer denials and improved coverage understanding
- Confirmed customer information and insurance eligibility for prescriptions
- Expedited prescription refills with timely coordination between patients, prescribers, and insurance claims.
Digital shopper
Walmart
11.2019 - 03.2021
- Served customers with knowledgeable, friendly support at every stage of shopping and purchasing
- Placed completed orders in labeled, temperature-appropriate storage pending customer pick up
- Reviews orders prior to pick up for accuracy and purchase-by dates
- Delivered items to customers on desired schedules by managing time efficiently and planning effective routes
- Confirmed all selected items were in excellent condition with intact packages
- Scanned each item’s barcode before item’s removal from shelf
Server
Golden Corral
06.2017 - 03.2019
- Arranged tables for customers, following established preparation procedures to provide guests with excellent experiences and foster repeat business
- Kept updated knowledge of menu and promotions, recommending specific items according to preferences and food allergies
- Delivered prompt and courteous service to over 100 guests daily, achieving a 95% customer satisfaction rate as measured by post-dining surveys
- Assisted in maximizing team efficiency by collaborating with kitchen and floor staff, which decreased order wait times and enhanced guest dining experiences
Assistant manager
KJ’s Soul Food
11.2010 - 01.2014
- Duties included everything from waiting tables, cook, stocking, cleaning, cashier inventory, and handling payroll
- Developed loyal and highly satisfied customer base through proactive management of team customer service strategies
- Achieved recognition from senior management for contribution to store success, including managing sales, employees and operations to foster optimal performance
Nanny
Apromise Care
01.2008 - 12.2012
- Monitored schedules to maintain sleeping, eating and school schedules for children
- Established lasting, professional connections with families and children by encouraging open communication and delivering positive feedback
- Developed personalized educational activities and care plans for toddlers, enhancing cognitive skills and emotional development by 50%, utilizing Montessori techniques and sensory play tools
- Engaged children in educational and creative activities, achieving improvement in their cognitive and social skills over a 6-month period through personalized play and learning sessions
Childcare provider
Wake County Child Care subsidy
05.2007 - 05.2009
- Maintained effective schedule balance between rest periods, active play and instruction
- Enforced rules and managed behavior through developmentally appropriate discipline
- Prepared healthy foods and beverages for children based on optimal dietary guidelines and individual restrictions
- Sanitized dishes, tabletops, toys and frequently touched surfaces to prevent spreading of germs
- Created and implemented diverse educational strategies to boost development
- Kept all areas neat, clean and properly sanitized
- Created safe and engaging learning environment for groups of diverse children with various learning styles
Education
Bachelors - Business Administration And Management
Strayer University
Washington, DC01.2027
GED - undefined
Guilford Tech Community College
High Point, NC01.2011
Skills
- Customer assistance
- Identification Checks
- A positive attitude and one-for-all team mentality and excellent collaboration skills
- Accurate money handling
- Sales proficiency
- Product knowledge
- Experience with chat support
- Online ordering familiarity
- Type 45wpm
- Excellent written and verbal communication skills
- The ability to adapt quickly and manage any responsibilities
- Recruiting and Interviewing
- Consulting
- Strategic Planning
- Order Fulfillment
Timeline
Pharmacy Help Desk-Temporary Remote Position
Results-CX
06.2020 - 06.2022
Digital shopper
Walmart
11.2019 - 03.2021
Server
Golden Corral
06.2017 - 03.2019
Assistant manager
KJ’s Soul Food
11.2010 - 01.2014
Nanny
Apromise Care
01.2008 - 12.2012
Childcare provider
Wake County Child Care subsidy
05.2007 - 05.2009
GED - undefined
Guilford Tech Community College
Bachelors - Business Administration And Management
Strayer University
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