Venicia Hughes

I help patients navigate the complex process of obtaining access to prescribed medications.Biologics Coordinator/Medication Prior Authorization Specialist efforts entail using Cover My Meds, communicating with insurance providers, completing enrollment forms, reviewing benefit verifications, submitting prior authorizations, writing appeals and letters of medical necessity, directing patient assistance and bridge programs, and coordinating all efforts of specialty pharmacies and manufacturer HUBS.

• Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
• Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
• Improved patient satisfaction with timely and accurate processing of prior authorizations for medications and procedures.
• Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
• Provided training to new staff members on the intricacies of various insurance plans and their specific prior authorization requirements.
• Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
• Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
• Responded to inquiries from healthcare providers regarding prior authorization requests.
• Input all patient data regarding claims and prior authorizations into system accurately.
• Analyzed medical records and other documents to determine approval of requests for authorization.
• Communicated with people from various cultures and backgrounds on application process.
• Assisted clients with completion of applications and paperwork.

• Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
• Developed and implemented improvements to pharmacy organization system.
• Precisely measured and combined ingredients to deliver scrupulous formulation on customer prescription orders.
• Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
• Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
• Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
• Counseled customers on medications, appropriate dosage and potential side effects.
• Coordinated verification and filling of more than 500 daily prescriptions in high-volume pharmacy environment.
• Resolved third-party billing, computer system and customer service issues.
• Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy
• Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
• Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Set up and modified patient profiles to include current medications and insurance details.
• Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
• Welcomed customers to pharmacy and answered questions relating to prescriptions and over-the-counter products.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
• Collected co-payments or full payments from customers.
• Stocked, labeled, and inventoried medication to keep accurate records.
• Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
• Data entry of customer accounts.
• Employee scheduling.
• Printing patient records, according to HIPPA.
• Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
• Ordered front end merchandise including gift department.
• Talked with vendors and salespeople.
• Paid invoices and filed those invoices.