Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Tamara Matthews

Tallahassee,US

Summary

Knowledgeable claims resolution with rich background in managing pharmacy benefits and ensuring optimal value for clients. Successfully implemented key strategies to streamline operations and improve member satisfaction. Demonstrated expertise in formulary management and contract negotiations.

Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.

Overview

10
10
years of professional experience

Work History

Pharmacy Benefits Manager

UnitedHealth Care
03.2021 - 09.2025
  • Manage pharmacy benefit plans, ensuring cost-effectiveness and patient care quality.
  • Conducted in-depth evaluations of pharmacy benefit plans, resulting in optimized cost structures and enhanced patient satisfaction.
  • Analyzed prescription drug utilization trends to enhance formulary management.
  • Developed and implemented pharmacy benefit strategies to optimize cost management.
  • Collaborated with healthcare providers to address medication adherence issues.
  • Facilitated open enrollment processes, enhancing communication of benefit options to employees.

Technology Analyst

ADT
07.2017 - 02.2021
  • Enhanced client relations by resolving complex issues, boosting satisfaction and usability.
  • Managed 35 daily customer calls, maintaining professionalism under pressure.
  • Delivered timely technical support, enhancing product usability and achieving noticeable results in customer satisfaction.
  • Resolved customer inquiries through effective troubleshooting of security system issues.
  • Monitored system performance metrics, driving proactive measures for enhanced reliability and security services.
  • Provided technical support for hardware and software issues, ensuring timely resolutions to enhance user productivity.

Medical Claims Coordinator

Sutherland Healthcare Solutions
11.2015 - 05.2017
  • Processed medical claims efficiently, ensuring compliance with industry regulations and guidelines.
  • Reviewed and analyzed claims for accuracy, identifying discrepancies and initiating resolutions promptly.
  • Utilized electronic claims processing systems to streamline workflows and enhance data accuracy.
  • Verified patient insurance coverage and benefits for medical claims.
  • Managed large volume of medical claims on daily basis.
  • Maintained a thorough understanding of the intricacies involved in processing medical claims for diverse healthcare specialties, enabling accurate and efficient claim adjudication.

Education

Bachelor of Arts - Mass Communications

Mississippi Valley State University
Itta Bena, MS
12.2017

Skills

  • Medical Insurance
  • Benefit Auditing
  • HIPAA Compliance
  • Customer Service
  • Technical Support
  • Problem Solving
  • Claims Resolution
  • Client Relations
  • Quality Improvement
  • Medication therapy management

Accomplishments

  • Resolved product issue through consumer testing.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Timeline

Pharmacy Benefits Manager

UnitedHealth Care
03.2021 - 09.2025

Technology Analyst

ADT
07.2017 - 02.2021

Medical Claims Coordinator

Sutherland Healthcare Solutions
11.2015 - 05.2017

Bachelor of Arts - Mass Communications

Mississippi Valley State University

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