Biologist with background in food safety and healthcare seeking an entry level healthcare position with opportunities for professional growth.
Skills
Effective workflow management
Microsoft Outlook, Word and Excel
Effective problem solver
Excellent time management skills
Attention to detail
Quick learner
Exceptional interpersonal communication
Skilled trainer
Trained in HIPPA compliance
Work History
September 2015-CurrentClinical Review Technician | Prime Therapeutics | Eagan, MN
Reviewing and processing Prior Authorization requests for Blue Cross Blue Shield members. Processing claims for different Utilization Management programs including Step Therapy, Quantity Exceptions, Formulary Exceptions and specific client reviews. Applying a working knowledge of Clinical Review Engine and RxCLAIM systems with additional databases and resources to determine the final outcome of clinical review requests. Analyzing review criteria, following process flow and conducting outreach to ensure compliance with Clinical Review standards.Promoted to Mentor of the Clinical Review Technician team to assist in answering questions and problem solving with the processes.
Effectively resolved insurance rejections and other billing issues.
Determined prior authorizations for medication and outpatient procedures.
August 2013-May 2015Student Manager | Chartwells | Winona, MN
Provide leadership and strong communication skills for the student workers in the college cafeteria during food service hours. Ensured quality of the food and a healthy and safety of the work area for workers and customers. Trained in new employees and seasoned employees on new positions and skills needed to provide excellent service to customers.
Ensured freshness of food and ingredients by checking for quality, keeping track of old and new items, and rotating stock
Inspected and cleaned food preparation areas to ensure safe and sanitary food-handling practices
Solved unresolved customer issues.
Managed work flow to exceed quality service goals.
Cross-trained and backed up other customer service workers.
Education
2015Bachelor of Science: BiologyWinona State University, Winona, MN
Accomplishments
A year of Capstone studying with the Dean of Biology supervising to present my work at the Mississippi River Research Consortium.
