Analyst with extensive experience in pharmacy audit. Proficiencies include strong computer skills and prioritizes/organizes workload to meet deadlines.
Experience
06/2016 to Current
Pharmacy Audit AnalystUnited Health Group OptumRx － Irvine, Ca
Manager: Kathryn Ton.
Reviews and analyzes claims data.
Claim processing and applying knowledge of pharmacy practice and data mining techniques to determine overpayment billing activity.
Assist with PARC process
Identifies and documents FWA
Work with other team members to ensure pharmacies get paid in a timely and properly.
Collaborate and work with clients to resolve audit/appeal inquiries.
09/2013 to 06/2016
Sr. Pharmacy Auditor RepresentativeUnited Health Group OptumRx － Irvine, Ca
Identify perpetual activity and prevent continued occurrence of.
wrong drug/ drug quantity bill by pharmacies.
Serve as subject matter expert for fraud, waste, abuse and error for client.
Prepare Analysis on Pharmacies and review audit samples of the prescriptions.
Prepare/ analyze in detail of different Drug reports.
Merging data/reports.
Analytical and interpretation skills to identify/ reduce in medication billing errors.
Analyzing in detail of Compound claims and Muti-Ingredient Report.
09/2004 to 09/2013
Lead Pharmacy TechnicianSaddleback Valley Pharmacy － Laguna Hills, Ca
Supervisor: Anne Tran, R.Ph
Compound drugs billing.
Processing prescription, communicate with doctors, nurse and
Patients.
Provided onsite training.
Knows trade names of many generic drug products.
Monitored multiple databases to keep track of all company inventory.
Run pharmacy monthly, annually drugs report and determine patterns/trends.
Education and Training
09/2006
Biological ScienceUniversity of California － IrvineBiological Science
06/2002
Magnolia High School
06/2000
John Glenn High School
Additional Information
License:
07/2007- Present Pharmacy Technician and National Licenses
License Registration Number: 77112
