Summary
Overview
Work History
Education
Skills
Timeline
Generic

Sharata Walters

College Park,Georgia

Summary

With over fourteen years of experience in the healthcare and pharmacy sector, including a pivotal role in positions held., I excel in process improvement and team leadership. Demonstrated expertise in HIPAA and healthcare systems navigation, I have a proven track record of enhancing productivity and resolving complex reimbursement issues efficiently. Seasoned Rebate Analyst with background in financial data analysis and revenue reconciliation. Experienced in maintaining accurate rebate records, ensuring compliance with contractual agreements, and providing analytical support for rebate-related disputes. Strengths include strong analytical skills, ability to interpret complex data, and proficiency in financial software tools. Previous roles marked by improved process efficiency and increased accuracy of rebate calculations.

Overview

15
15
years of professional experience

Work History

Rebate Analysis Services Associate III

Conduent
01.2015 - Current
  • Assist with validating units of measure from Centers for Medicare & Medicaid Services file to Medicaid Management Information Systems drug file for consistency
  • Produce rebate adjustments based on retroactively corrected rebate data
  • Determines paid claims data amount of rebate due and generates data
  • Tracks and updates rebate amounts due and received in the Drug Rebate Analysis & Management Systems
  • Obtains supporting documentation when needed
  • Assist in the development and implementation of additional reporting support tools, and the proactive investigation of various manufacturer issues and identify opportunities for process improvement
  • Evaluate and streamline workflows by identifying process inefficiencies, implementing structured improvements that enhance productivity, minimize errors, and increase task
  • Analyzes disputed data and works with drug manufacturers to fairly and accurately resolve disputes
  • Responsible for interpreting small to intermediate pharmaceutical manufacturer payment distribution issues
  • This includes all aspects of the contract from formulary compliance, to system capabilities to reconciliation and allocation of payments to clients
  • Handles business issues of basic complexity on a routine basis independently
  • Demonstrates clerical tasks of general filing and records maintenance, preparing routine correspondence, word processing, compiling data for reports, preparing/editing presentations, verifying data, completing forms, data entry, processing various documents (i.e
  • Claims forms and invoices), maintaining records, account reconciliation, distributing mail, duplicating, and other established general clerical tasks
  • Analyzing problems, identifying root causes and assisting with driving practical and creative solutions

Reimbursement Pharmacy Technician

Grady Memorial Hospital
01.2010 - 01.2015
  • Responded to patient inquiries (phone, written or walk in) regarding all aspects of pharmacy business, eligibility and claims in a professional, timely manner
  • Allocated funds from resubmission of payment
  • Collected patient specific data for prescription and billing processing including but not limited to third party payers, delivery preferences, etc
  • Maintained productivity expectations
  • Worked insurance rejects including: Prior Authorizations, Cost Exceeds Maximum, Maximum Day Supply, Maximum Quantity per Fill, Age Exceeds Plan Limits, Filled after Coverage Expired, Refill Doctor and other edits
  • Trained other staff on day-to-day operations
  • Used knowledge of medical terminology to ensure accuracy of prescriptions
  • Operated and used appropriate techniques within RX30 and PharmAssist for storage, preparation and dispensing of pharmaceutical agents and follow the healthcare centers policies regarding medication preparation and labeling, controlled substances reconciliation, purchasing of medication and supplies

Education

Diploma - Pharmacy Technician

Medix
01.2005

Skills

  • Over fourteen years of experience in pharmacy and healthcare
  • Knowledge of HIPAA, NCPDP, DSMO, ANSI, CMS, NPI, and HITECH
  • Process Improvement and Optimization
  • Training coordination
  • Team leadership
  • Healthcare systems navigation
  • Team collaboration
  • Resource allocation

Timeline

Rebate Analysis Services Associate III

Conduent
01.2015 - Current

Reimbursement Pharmacy Technician

Grady Memorial Hospital
01.2010 - 01.2015

Diploma - Pharmacy Technician

Medix

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Sharata Walters