Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Rimpal Patel

Lowell

Summary

Pharmacy professional possessing extensive expertise in clinical compliance and data interpretation at BMC, achieving enhanced patient interactions and optimized prior authorization processes, significantly boosting operational efficiency.

Overview

11
11
years of professional experience

Work History

Pharmacy Prior Authorization

BMC
Boston
07.2023 - 08.2024
  • Received, processed, and reviewed all prior authorization requests through fax, phone or electronic prior authorization systems in accordance with all regulatory and accreditation requirements
  • Communicated determinations to members, providers, pharmacists, and RN via incoming and outgoing telephone calls, fax notifications, and letter notifications.
  • Interpreted medical and pharmacy data and accurately enters information into system according to regulatory and NCQA accreditation requirement
  • Properly applied clinical policy criteria to the review of prior authorization requests
  • Reviewed and interpreted member eligibility, claim history, and Pharmacy Program information using the PBM claims software to provide information to both internal and external clients via telephone or emails.

Pharmacy Technician

CVS
Lowell
10.2022 - 05.2023
  • Organized medication for the pharmacist to review by profiling prescriptions, preparing labels, and calculating quantities; met time-to-floor benchmarks 100% of the time
  • Used medication input software to dispense medication safely and accurately
  • Packed and labeled prescribed medication
  • Provided friendly customer service phone screen to remind their refills
  • Identified medications, NDC codes and tracked dates

Interpreter/Caregiver

BayStates Interpreter/Inform Interpreter
08.2021 - 10.2022
  • Provided translation and interpretation assistance in Gujarati language reviewed and translated documents
  • Interpreted conversations at Dialysis center, hospital, and home health care service
  • Provided interpretation services in-person, via live virtual appointments, and over the phone

Medical Assistant

Northeast Medical Group
Boston
06.2013 - 08.2019
  • Managed prescription refill procedures and maintained patient record confidentiality
  • Managed office telephone systems, including answering calls and returning messages
  • Scheduled and confirmed patient appointments
  • Maintained accurate documentation of patient's medical history and health insurance data and called for Prior Authorization to approval from the health plan
  • Coordinated daily office activities and checked patients in and out for their appointments and recorded patient and lab charges for the billing department

Education

Pharmacy Technician License (CPhT) -

Commonwealth of Massachusetts
12.2026

Certification Medical Billing And Coding Fundamentals - Medical Billing And Coding Fundamentals

Med Certs A Stride Company
05-2025

Pharmacy Technician Certification Board Certified - Pharmacy Technician

Jewish Vocational Service
Boston, MA
09.2024

Pharmacy Technician Training Program -

Jewish Vocational Service
Boston, MA
12.2022

Certification of Professional Interpreter - Language Interpretation And Translation

Cross Cultural Communiction System
Woburn, MA
07.2021

Skills

  • Pharmacy management
  • Medical billing and coding
  • Clinical compliance
  • Data interpretation
  • Professional communication
  • Customer service and support
  • Human anatomy and terminology
  • Insurance verification and processing
  • Revenue analysis
  • Critical thinking and problem solving
  • Organizational skills
  • Patient interaction
  • Microsoft Office proficiency

Languages

English,Gujarati,Hindi
Native/ Bilingual

Timeline

Pharmacy Prior Authorization

BMC
07.2023 - 08.2024

Pharmacy Technician

CVS
10.2022 - 05.2023

Interpreter/Caregiver

BayStates Interpreter/Inform Interpreter
08.2021 - 10.2022

Medical Assistant

Northeast Medical Group
06.2013 - 08.2019

Pharmacy Technician License (CPhT) -

Commonwealth of Massachusetts

Certification Medical Billing And Coding Fundamentals - Medical Billing And Coding Fundamentals

Med Certs A Stride Company

Pharmacy Technician Certification Board Certified - Pharmacy Technician

Jewish Vocational Service

Pharmacy Technician Training Program -

Jewish Vocational Service

Certification of Professional Interpreter - Language Interpretation And Translation

Cross Cultural Communiction System

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