Renee Cooper

Complete daily reject reports which consist of coverage determinations, opioid rejects, hard rejects, and reprocessed claims.

Make outreaches to providers for coverage determinations when necessary via fax or phone.

Make outreaches to pharmacies to reprocess claims or assist pharmacies with Hard DUR rejects, overrides, opioid rejects, and reprocessing of claims.

Complete Disenrollment and LIS reports (extra help for drug prescriptions) in accordance with CMS guidelines.

Complete adherence outreach calls to members who have a gap with prescription fills.

Managed member inquiries, ensuring accurate information delivery and enhanced customer satisfaction

Collaborated with cross-functional teams to streamline enrollment processes and reduce wait times.

Follow all policy, rules, and regulations according to CMS guidelines

Assisted in developing communication strategies to inform members about policy changes and health programs.

Implemented best practices for claims processing, resulting in increased accuracy and reduced errors

Handled customer complaints quickly and professionally to restore customer confidence and prevent loss of business.

Increased customer satisfaction by addressing and resolving complaints in a timely manner.

Enhanced company reputation by providing exceptional customer service and support.

Greeted customers warmly to set tone of customer experience and provide welcoming and friendly atmosphere.

Processed and dispensed medications accurately in compliance with pharmacy regulations.

Hands on experience with robot to assist high volume of medication fills for long term care pharmacy

Assisted pharmacists in managing inventory levels, ensuring timely restocking of essential medications.

Prepared compound drugs, vials, and blister packs.

Packaged medication to prepare for delivery to facilities.

Prepared and sterilized IV pumps to be dispensed.

Maintained cleanliness and organization of work areas, adhering to safety and health standards.

Assisting billing department when needed to meet demand of prescriptions to be filled at a timely manner.

Conducted quality assurance checks on prescriptions to ensure accuracy before dispensing to patients.

Stocked, labeled, and inventoried medication to keep accurate records.

Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.

Maintained education and pharmacy technician license.

Increased overall pharmacy productivity by restocking supplies, organizing shelves, and maintaining cleanliness according to standards.

Processed and filled prescriptions accurately, ensuring adherence to safety protocols with high volume prescription fills.

Managed inventory levels, conducting regular audits to prevent stock shortages.

Assisted pharmacists in patient consultation, enhancing medication understanding and compliance when appropriate.

Trained junior staff on pharmacy operations and best practices for efficiency.

Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.

Increased customer satisfaction by delivering friendly, personalized service during transactions.

Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.

Stocked, labeled, and inventoried medication to keep accurate records.

Answered incoming phone calls and addressed questions from customers and healthcare providers.

Completed paperwork, entering prescription and insurance or billing information into patient profiles.

Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.

Monitored expiration dates of medications, ensuring timely removal of outdated.

Collaborated with healthcare providers to resolve medication-related inquiries effectively.