Sue Ellen Gerena
Summary
Experienced Pharmacy Technician knowledgeable in all facets of pharmacy operations, eager to bring talent and expertise to your company. Successful in managing a large team of pharmacy technicians in data entry, adjudication, and fulfillment. Great at building relationships with customers for sustained business growth and customer retention. Team-oriented and dedicated to collaboratively delivering exceptional customer service. Safety-oriented and well-organized with solid experience coordinating with insurance providers, prescribers and individuals to address issues.
Overview
10
10
years of professional experience
Work History
Adjudication Manager
Medwiz Pharmacy LLC
Cherry Hill, NJ
01.2024 - Current
- Manage off-shore and stateside pharmacy technicians working on all adjudicated claims for our 5 LTC pharmacy locations
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maintained professional, organized, and safe environment for employees and patrons.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Onboarded new employees with training and new hire documentation.
- Maximized performance by monitoring daily activities and mentoring team members.
- Cross-trained existing employees to maximize team agility and performance.
- Increased patient satisfaction by efficiently processing insurance claims and addressing inquiries.
- Reduced claim denials by verifying patient eligibility and coverage details prior to submission.
- Assisted management in developing policies and procedures for streamlined billing processes, ensuring accuracy and compliance across the department.
- Implemented efficient workflows within the department, leading to a reduction in processing time for each claim submitted.
Data Entry and Rejection Specialist Lead
Medwiz Pharmacy LLC
Cherry Hill, NJ
12.2022 - 01.2024
- LTC pharmacy that delivers medication to 30 nursing and assisted living facilities
- Enter faxed and electronic prescriptions into our pharmacy system (Docuwiz and Frameworks)
- Work insurance rejections- call insurance companies and facilities for copay approvals
- Take inbound calls from facilities and help with refills, questions they may have about orders, deliveries
- Call on clarifications on prescriptions that are not clear or need something changed
- In charge of printing MARs, TARs, and POs
- Lead on our Dispil facility- from data entry, filling, and shipping.
- Developed strong client relationships through consistent communication and attentive service.
- Oversaw daily operations of a busy office environment, ensuring tasks were completed efficiently and accurately.
Processing Manager
AdventHealth RxPlus Pharmacy (Mail Order)
06.2019 - 12.2022
- Manage a team of 25 pharmacy technicians
- In charge of hiring/terminating/action planning
- Implements pharmacy procedures and performance standards
- Developmental conversations with the team
- Subject Matter Expert of pharmacy software (Guardian-Carepoint)
- Lead projects/Sets departmental goals
- Weekly PBM calls with MedImpact
- Work closely with our Pharmacy IT-IS Team to work through issues with our pharmacy software/vendors
- Involved with CQI matters/investigations of errors made.
Processing Supervisor
AdventHealth RxPlus Pharmacy (Mail Order)
05.2015 - 06.2019
- Supervise a team of 18 pharmacy technicians
- Train all new hire technicians and internal technicians on processing procedures
- Problem solving- insurance rejections
- Handle private patient health information
- Obtaining, processing, billing, and charging of orders
- Evaluations with team members: One-on-One's, yearly evaluations, mediations
- Developed professional, trusting relationships across all work groups in the pharmacy
- Monitors and delegates when other areas need help and jumps into the queues where needed
- Makes weekly technician schedules to help set daily goals
- Help buyers out with green cards/NDC changes
- Downtime Committee with our IT department.
Processing Technician
AdventHealth RxPlus Pharmacy (Mail Order)
02.2014 - 05.2015
- Typed all incoming prescriptions
- Monitored my own queue
- Faxed clarifications to doctors' offices
- Problem solving- insurance rejections
- Handle private patient health information
- Obtaining, processing, billing, and charging of orders
- Trained new hires as technicians.
Education
Bachelors in Information Technology, General IT -
Capella University
Minneapolis, MN12.2022
Associate of Science in Information System Technology -
Seminole State College
Lake Mary, FL01.2019
Skills
- Customer Relations
- Expert Problem Solving
- Documentation Management
- Quality Assurance
- Workflow Optimization
- Pharmacy operations management
- Training and mentoring
- Confidentiality and HIPAA
- Insurance Billing
- Policy Enforcement
Licensure Certification
- New Jersey Registered Pharmacy Technician, 28RW05406700, Clear/Active, Exp August 31, 2024
- Florida Registered Pharmacy Technician, RPT21243, Clear/Active, 12/31/2024
- PTCB Certified Technician, 30208673, Exp August 31, 2024
Timeline
Adjudication Manager
Medwiz Pharmacy LLC
01.2024 - Current
Data Entry and Rejection Specialist Lead
Medwiz Pharmacy LLC
12.2022 - 01.2024
Processing Manager
AdventHealth RxPlus Pharmacy (Mail Order)
06.2019 - 12.2022
Processing Supervisor
AdventHealth RxPlus Pharmacy (Mail Order)
05.2015 - 06.2019
Processing Technician
AdventHealth RxPlus Pharmacy (Mail Order)
02.2014 - 05.2015
Bachelors in Information Technology, General IT -
Capella University
Associate of Science in Information System Technology -
Seminole State College