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Clinical Pharmacy Technician Resume Example

Resume Score: 80%

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CLINICAL PHARMACY TECHNICIAN
Professional Summary

Conscientious Data Entry with exceptional Customer Service skills, pharmaceutical knowledge and Firstrax skills. Deliver exceptional customer service and accurate prescription fulfillment. Driven Pharmacy Technician with 22 years of experience and success in working within fast-paced Long Term pharmacy settings. Highly proficient in accurately filling and labeling prescriptions, maintaining drug inventories and updating pharmacy records. Excited to bring talent and record of excellence in customer service to growing pharmacy. Detail-oriented reimbursement specialist with expertise in Customer Service developed over 22 years of industry experience. Execute both clinical and retail functions proficiently to drive customer satisfaction. Capable pharmacy team member proficient in assisting pharmacists with preparing prescriptions and meeting customer needs. Safety-oriented and well-organized with solid experience coordinating with insurance providers, prescribers and individuals to address issues. Good relationship-building and multitasking skills. Efficient Med A-D billing recognized for effectively performing all pharmacist duties in -hour store, averaging 50-60 prescriptions daily. Organized and respectful professional capable of maintaining flexible schedule and adapting to unique business and customer needs. In-depth knowledge of medical terminology, pharmaceutical storage and inventory management.

Skills
  • Billing
  • Data entry
  • Insurance
  • Pharmacy Technician
  • Patient education and counseling
  • Processing payments
  • Financial Management
Work History
Clinical Pharmacy Technician, 11/2011 to 03/2020
Company Name – City, State
  • Prior Authorizations for Colorado Medicaid
  • Processing and Reversing Claims
  • Assisting Members with their Medicaid Insurance
  • Consulting with Pharmacist regarding members medications
  • Reviewing paid and rejected claims
  • Troubleshooting rejected claim issues
  • Researching duplicating claims
  • Interacting with customers, nurses, doctors and pharmacist
  • Authorizations for commercial insurance
  • Taking inbound calls
  • Reviewing Colorado's Medicaid Criteria and private insurance (Contract) CVS/Caremark St
  • John, MO
Billing Specialist, 10/2014 to 08/2016
Company Name – City, State
  • Maintain and release all ship-verified claims from bill review within three days
  • Develop a tickler file and hold all claims pending authorization and or documentation
  • Analyze and verify all dates of service and billed amounts
  • Verifies all client data for completeness and accuracy prior to billing cycle
  • Performs all other adjustments in a timely manner to reconcile accounts
  • Contacting the VA inquiring about prior authorizations which is needed for any medications being dispensed
  • Working with Contracts while submitting HCFA 1500 Claim Form
  • Correcting errors on claim forms and resubmitting HCFA Claim Forms
  • Medicare A and B Knowledge
  • Meeting Deadlines Accuscripts Pharmacy
Billing Specialist, 10/2012 to 09/2014
Company Name – City, State
  • Taking inbound calls from Nursing Facilities, Patients, Power of Attorney's, and Director of Nursing about patient's billing issues
  • Worked Daily Census for Medicare A and Managed Care patients
  • Meeting deadlines for Nursing Facilities to receive their Medicare A Billing in a timely fashion
  • Making outbound calls to Nursing Facilities in reference to patient's correct Medicare A days
  • Assisted Patients with billing issues and contacting the insurance company regarding copay issues for patients
  • Documenting check and credit card payments as they were received
  • Maintain and release all ship-verified claims from bill review within three days
  • Develop a tickler file and hold all claims pending authorization and or documentation
  • Analyze and verify all dates of service and billed amounts
  • Verifies all client data for completeness and accuracy prior to billing cycle
  • Performs all other adjustments in a timely manner to reconcile accounts
  • Contacting the VA inquiring about prior authorizations which is needed for any medications being dispensed
  • Working with Contracts while submitting HCFA 1500 Claim Form
  • Correcting errors on claim forms and resubmitting HCFA Claim Forms
Medical Records/Billing Specialist, 03/2001 to 09/2012
Company Name – City, State
  • Entered all non-medication orders and medication orders into customer specific profiles for assigned centers in the pharmacy computer system
  • Received physician order sheets and telephone orders and monthly filing for future archive storage
  • Assisted with conversions and new home startups along with pharmacy data entry as required
  • Reviewed and edited monthly physicians order forms and telephone orders returned to pharmacy
  • Managed discharges, room changes and doctor changes on profile
  • Developing relationships with facilities to get a better understanding of their needs, so that the correct services could be provided accurately
  • Dealing with Insurance Caps over $100 and contacting patients and insurance companies
  • Rewriting prescriptions from brand to generic as specified by insurance companies
  • Working from Excel spreadsheets
  • Maintain and release all ship-verified claims from bill review within three days
  • Develop a tickler file and hold all claims pending authorization and or documentation
  • Analyze and verify all dates of service and billed amounts
  • Verifies all client data for completeness and accuracy prior to billing cycle
  • Performs all other adjustments in a timely manner to reconcile accounts
  • Contacting the VA inquiring about prior authorizations which is needed for any medications being dispensed
  • Working with Contracts while submitting HCFA 1500 Claim Form
  • Correcting errors on claim forms and resubmitting HCFA Claim Forms 1 Maintain and release all ship-verified claims from bill review within
  • Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments
  • Identified, researched and resolved billing variances to maintain system accuracy and currency
  • Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts
  • Kept vendor files accurate and up-to-date to expedite payment processing
  • Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft
Education
Bachelor of Science: Healthcare Management , 2020
University of Phoenix - City, State
Master of Science: Healthcare Management, 2020
University of Phoenix - City
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Resume Overview

School Attended

  • University of Phoenix

Job Titles Held:

  • Clinical Pharmacy Technician
  • Billing Specialist
  • Medical Records/Billing Specialist

Degrees

  • Bachelor of Science : Healthcare Management , 2020
    Master of Science : Healthcare Management , 2020

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