Summary
Overview
Work History
Education
Skills
References
Timeline
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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
Victoria Ruiz