Tranelle Davis
Gretna,La
Summary
Certified Pharmacy Technician with 8+years of experience in data entry with 98% accuracy , investigating insurance benefits and prior authorizations , providing excellent customer service, and a forward thinker team player in both retail and specialty pharmacy settings. Dedicated and have an exceptional work ethic. Proven record implementing processes to improve productivity and great multitasking skills. I am eager to expand my knowledge in my pharmacy career with this company.
Overview
18
18
years of professional experience
Work History
Pharmacy Technician II
Centene, Superior Health Services
New Orleans, Louisiana
08.2023 - Current
- Performed data entry for patient profiles, billing information and prescription orders into the pharmacy software system.
- Ensured compliance with all federal, state, local laws and company policies related to pharmacy operations.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Provided guidance to providers regarding the prior authorization process.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Maintained accurate records of all authorization activities in the database system.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.
Pharmacy Technician II
Apex Solutions/Centene Pharmacy
New Orleans, Louisiana
10.2022 - 08.2023
- Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required· Obtain verbal authorizations and request detailed clinical information from prescribers· Approve coverage determination requests based on defined criteria· Enter and document coverage determination request decision into the PBM system and notify providers and/or members· Respond to client inquiries regarding authorization approvals and PBM on-line applications· Refer coverage determination requests for specialty drugs to delegated vendor or client for processing· Contact providers for additional information to facilitate coverage determination reviews· Notify physicians, providers and members of coverage determination request decisions
Certified Pharmacy Technician
Kroger Specialty Pharmacy
Harvey, LA
04.2018 - 10.2022
- Data entry while reviewing prescriptions for accuracy
- Prior authorization support
- Respond to inbound calls from patients/clinicians and triage to appropriate departments
- Demonstrate excellent customer service skills
- Benefit investigation
- Complete assessments mandated by manufacturers
- Resolve and adjudicate prescription insurance claims
- Maintained strict patient confidentiality to adhere to HIPAA regulations and avoid data compromises.
- Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
- Determined eligibility for coverage based on policy terms and provided explanations of findings to claimants.
- Reviewed and processed incoming claims to determine applicable coverage.
Certified Pharmacy Technician
TRANELLE DAVIS, Winn Dixie Pharmacy
New Orleans, La
07.2015 - 04.2018
- Data entry
- Consulted with customers via telephone or in-person to assist with navigating pharmacy systems and completing requests.
- Received, reviewed, dispensed and labeled over 250 prescriptions daily.
- Maintained clean and organized pharmacy shelving and work areas.
- Verified patients' identities at pickup to prevent sale of wrong medications.
- Managed inventories, rotated stock, removed expired or damaged drug products and resolved discrepancies in drug counts.
- Efficiently processed cash register transactions for new and refilled prescription orders.
- Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions.
Customer Service
Winn Dixie Supermarket
New Orleans, Louisiana
11.2007 - 07.2015
- Managed accurate recordkeeping by distributing invoices, collecting payments and updating logs.
- Processed payments promptly for customers to exceed productivity standards.
- Scanned, priced and bagged customer groceries quickly to keep lines moving.
- Assisted management with developing and managing employee improvement strategies to encourage exceptional performance from staff.
Cashier
Winn Dixie
New Orleans, Louisiana
- Assist customers
- Proficient in customer service highly reliable and responsible
- Collected payments and provided accurate change.
- Helped customers find specific products, answered questions and offered product advice.
- Worked closely with front-end staff to assist customers.
- Processed sales transactions to prevent long customer wait times.
Education
Bachelor of Science - Chemistry, Pharmacy
Xavier University of Louisiana
New Orleans, LA05.2015
Skills
- Excellent communication skills
- Workflow Optimization
- Consistent focus to detail to promote 100% accuracy with pharmacy verification
- Insurance Verification and claim resolution
- Proficient with pharmacy applications and computer operations
- Maintain knowledge of new developments
- Ability to adjust workflow to assist in any operations needed to promote quality requirements and meet schedules
Timeline
Pharmacy Technician II
Centene, Superior Health Services
08.2023 - Current
Pharmacy Technician II
Apex Solutions/Centene Pharmacy
10.2022 - 08.2023
Certified Pharmacy Technician
Kroger Specialty Pharmacy
04.2018 - 10.2022
Certified Pharmacy Technician
TRANELLE DAVIS, Winn Dixie Pharmacy
07.2015 - 04.2018
Customer Service
Winn Dixie Supermarket
11.2007 - 07.2015
Cashier
Winn Dixie
Bachelor of Science - Chemistry, Pharmacy
Xavier University of Louisiana