Work Preference
Summary
Overview
Work History
Education
Skills
Timeline
Generic
Open To Work

Visaury Lajara

Bronx,NY

Work Preference

Desired Job Title

Intake SpecialistEnrollment SpecialistCredentialing SpecialistAuthorization SpecialistClaims Representative

Work Type

Part TimeFull Time

Location Preference

RemoteHybrid
Location: Bronx, NY, USNew York, NYYonkers, NY
Open to relocation: Yes

Salary Range

55000/yr - 100000/yr

Important To Me

Career advancementWork-life balanceFlexible work hoursCompany CultureHealthcare benefitsWork from home optionPaid time offPaid sick leave401k match

Summary

Productive pharmacy specialist with proven track record of excellent customer service and consistent results. Possesses excellent communication skills, professional attitude and keen attention to detail. Dedicated to using latest technologies and processes to deliver highest level of efficiency.

Overview

15
15
years of professional experience

Work History

Pharmacy Specialist

MVP Healthcare
Tarrytown, NY
07.2025 - Current
  • Manage approximately 30 incoming faxes daily, determine eligibility, and evaluate pre-authorization requirements using multiple systems.
  • Contact providers for additional clinical information & send written notifications to members/providers regarding coverage determinations.
  • Support licensed pharmacists with daily tasks & maintain knowledge of diverse pharmacy formularies & policies.
  • Facilitate professional communication via phone & fax.

Customer Care Representative

MVP Healthcare
Tarrytown, NY
05.2024 - 06.2025
  • Achieved high levels of customer satisfaction through prompt resolution of escalated issues by liaising with relevant departments effectively.
  • Conducted thorough research on complex cases, ensuring accurate information is provided to policyholders.
  • Assisted in training new Member Services Representatives, sharing best practices for handling complex inquiries.
  • Educated customers about billing, payment processing and support policies and procedures.
  • Identified and resolved discrepancies and errors in customer accounts.

Outreach Specialist

EFamilyCare
New York, NY
06.2022 - 11.2023
  • Interviewed, screened, and enrolled prospective members.
  • Recorded, transcribed, and maintained confidential member information into applicant tracking system and database.
  • Effective liaison between prospective members and internal departments.
  • Provided feedback in order to improve company policies and procedures.

Member Services Representative

HealthFirst
New York, NY
11.2011 - 09.2017
  • Effectively managed approximately 40 inbound and outbound Medicaid member calls daily.
  • Addressed and resolved member complaints using the company system.
  • Conducted special outreaches to ensure that renewal applications were complete & accurate.
  • Researched member claims and authorization issues.

Education

Associate of Science - Accounting And Business Management

Bronx Community College
Bronx, NY
06-2017

Bachelor of Science - Health Services Administration

CUNY School of Professional Studies
New York, NY
12-2027

Skills

  • Microsoft Word, Excel, Outlook
  • HIPPA compliance
  • Fluent in English/Spanish
  • Exceptional workflow management
  • Maintaining Client Records
  • Customer Relationship Management (CRM)

Timeline

Pharmacy Specialist

MVP Healthcare
07.2025 - Current

Customer Care Representative

MVP Healthcare
05.2024 - 06.2025

Outreach Specialist

EFamilyCare
06.2022 - 11.2023

Member Services Representative

HealthFirst
11.2011 - 09.2017

Bachelor of Science - Health Services Administration

CUNY School of Professional Studies

Associate of Science - Accounting And Business Management

Bronx Community College

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Visaury Lajara