Experienced professional seeking to expand my horizons with the Quality Industry. Key Qualifications- Experience with computers- Fast computer typing - Good with technology - Good communication with people of all ages, from the elderly to the disabled - Great Math and English skills. Fast and most importantly thorough learner.
Overview
15
15
years of professional experience
Work History
Quality Specialist
CVS Specialty Pharmacy
03.2023 - Current
Complete a number of call audits for a range of Line's of Business including PSR, Benefits Verification, Technician, Pharmacist and more.
Summarize and complete call audits for Escalated Patient Complaints
Navigate and reference TheSource to assist in auditing phone calls to ensure compliance within the different areas of all of CVS Specialty
Benefits Verification Specialist
CVS Specialty Pharmacy
06.2022 - 03.2023
Process insurance claims
Keep patient insurance information updated
Research and resolve a variety of insurance rejections to get medication out the door
Research and resolve secondary insurance rejections
Initiate and follow up with prior authorization for specialty medications
Receive phone calls assisting other reps within the enterprise with insurance issues or system issues
Assisted with audits by preparing accounts and providing information.
Coordinated benefits processing, including enrollments, terminations and claims.
Command Center Representative
CVS Specialty Pharmacy
08.2019 - 06.2022
Initiating credit/reships when patient medication orders need to be reshipped due to UPS shipping error.
Assessing and resolving other miscellaneous UPS and shipping issues
Assisting colleagues from all over the map with Insurance Issues and order issus
Acting as a liaison between the front and back end pharmacy for Order Cancellations, urgent shipping and prescription changes needing Pharmacist approval and more.
Food Service Assistant
Saint Antoine Residence
06.2016 - 08.2019
Took orders, prepared foods and processed payments in full-service establishment.
Completed opening, closing and shift change tasks by following company guidelines.
Cleaned and sanitized work areas, equipment, utensils, dishes and silverware.
Followed staff performance and service standards to deliver consistent and positive customer experiences.
Received food orders from individuals and explained offerings.
Followed food safety regulations pertaining to sanitation, food handling and storage.
Maintained professional demeanor during interactions with customers and co-workers.
Performed variety of duties related to food service.
Set up, restocked and cleaned dining areas.
Maintained order and cleanliness of work areas to conform with health codes.
Dining Room Waitress and Supervisor
Saint Antoine Residence
03.2010 - 08.2019
Overseeing the dining room employees to make sure functions of the dining room (stocking, serving, assisting residents) is done properly
Reporting to kitchen supervisors of any issues that require their help in resolving
Scheduling of employees
Resolving any scheduling issues or call outs
Ensuring residents are happy and content with their meal and experience every day lunch and dinner
Arranged proper seating facilities to promote rules and regulations concerning safety, fire and health concerns.
Fielded complaints from customers and corrected issues with both front of house and kitchen staff.
Adhered to and enforced health and safety standards regarding food preparation, serving and storage.
Acted as liaison between head of kitchen staff and front of house to update staff on menu updates, special requests and canceled items.
Nutrition Assistant
Milford Regional Medical Center
06.2016 - 02.2017
Receiving phone calls from all over the hospital for meal orders according to the patients diet order
Answering any questions regarding a patients diet order or possible meal choices
Assisting patients in person that may have difficulty talking over the phone with picking out their meals and answering any questions they may have
Assisting residents by serving them meals that comply with their specified dietary needs
Interviewing new residents to get past and current food and health history
Communicating with some of the current residents as to what they would prefer to eat for next days meals
Reviewing 100+ residents meals for the next day using the Computrition software
Program according to their specific dietary restrictions
Calculating the number of meals to be prepared by the chefs.
Assisted dietitian by reporting on clients' progress with diet plans and identified issues.
Calculated calories, sugar, sodium and other nutrition information to monitor and maintain patients' intake.
Planned menus and ordered specific foods to meet medical restrictions.
Helped clients select appropriate foods for prescribed diets with help from registered nutritionist.