Victoria Ruiz
Albuquerque,NM
Summary
Pharmacy Technician with 24 years of experience in retail and managed care. Skilled in optimizing workflows, ensuring compliance, and delivering excellent patient care. Dedicated to contributing to healthcare teams through extensive knowledge and proactive problem-solving..
Overview
17
17
years of professional experience
Work History
Pharmacy Operations Representative
Blue Cross Blue Shield of NM
Albuquerque, NM
03.2020 - 03.2023
- Processed and approved pharmacy prior authorization requests following clinical guidelines.
- Provided timely updates to Healthcare providers on authorization decisions
- Directed complex cases to pharmacists for in-depth clinical review.
- Managed multiple task queues and assignments with precision, maintaining efficiency
- Kept current with office-administered prescription drugs, disease states, and health plan formulary management techniques.
Pharmacy Benefits Technician II
Presbyterian Health Plan
Albuquerque, NM
10.2015 - 03.2020
- Processed prior authorization requests received from providers.
- Addressed inquiries related to pharmacy benefits from both Senior Care and Commercial members.
- Monitored and implemented formulary updates across all business lines.
- Responded to inquiries from customer service representatives and providers about eligibility, copayment details, and prior authorization outcomes.
- Reviewed requests for Direct Member Reimbursement and determined outcomes.
- Addressed claims department inquiries regarding prior authorization of J codes.
- Participated in groups to implement new tools and systems, optimizing overall efficiency.
- Communicated potential enhancements in internal workflows to supervisors and lead technician.
- Trained pharmacy technician new hires, ensuring effective team integration
- Assisted with lead technician responsibilities in their absence
- Responded to inquiries from technicians, pharmacists, and other departments.
- Stayed current with benefits trends and legislation through continuous education and professional development.
Sr. Pharmacy Technician
Walgreens
Albuquerque, NM
02.2006 - 08.2014
- Entered new patient profiles and prescriptions into pharmacy system efficiently.
- Handled up to 550 prescriptions with precision on busy days.
- Checked accuracy of patient demographics and insurance billing data.
- Handled multi-line phone system, efficiently resolving inquiries and grievances from medical professionals and patients.
- Oversaw inventory management activities.
- Managed controlled drug registries with precision and ensured compliance with regulations.
Education
Associates of Arts - Liberal Arts
Central New Mexico Community College
12.2015
Skills
- Proficient data entry
- Efficient workflow management
- Patient Care Excellence
- Pharmacy Software Proficiency
- Regulatory Compliance
- Communication and Collaboration
- Experienced in Call Center Operations
References
Available upon request
Timeline
Pharmacy Operations Representative
Blue Cross Blue Shield of NM
03.2020 - 03.2023
Pharmacy Benefits Technician II
Presbyterian Health Plan
10.2015 - 03.2020
Sr. Pharmacy Technician
Walgreens
02.2006 - 08.2014
Associates of Arts - Liberal Arts
Central New Mexico Community College
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