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Pharmacy Benefits Management Resume Example

Resume Score: 90%

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PHARMACY BENEFITS MANAGEMENT
Career Overview
I am currently seeking an opportunity to earn a position as a Business Analyst. My background experience specializes in customer service, revision of analytical data, information systems management, administrative duties, and project management.
Qualifications
  • Microsoft Word, Excel, Powerpoint, Access, Unix, SQL and Outlook, Data Processing 50-60 WPM
Technical Skills
SkillsExperienceTotal YearsLast Used
SQL
Accomplishments
  • Certifications:.

Basic Life Support

Phlebotomy

Work Experience
01/2015 - Current
Medimpact Healthcare Systems - San Diego, CAPharmacy Benefits Management
  • Working with three departments: Formulary Operations, Benefits Configuration, and Pharmacy Networks to define quality metrics for business needs.
  • Testing & validation of pharmacy claims through data analysis.
  • SQL testing Jabber SalesForce QA of plan standards.
  • Meet deadlines for PG clients.
  • Handle incoming workload for Geisinger Health Plan, Health Partners, Kaiser, and Self-Insured Clients (levels 1,2 and projects).
  • Code pharmacy carriers, medications, and NDCs.
  • E2E testing & validation of coded claims.
  • Training incoming staff on Medimpact Software and Business Process.
01/2015 - 07/2015
Sharp Healthcare - San Diego, CaliforniaBusiness Services Representative
  • Registered new patients with the IDX system.
  • Verified and entered new insurance via phone/online.
  • Collected copays and deposits on deductibles.
  • Scanned new documents to Onbase.
  • Reported any emergent situations to registered nursing staff/ Assisted physicians Handled outgoing/incoming calls to internal and external personnel.
  • Peer reviews.
07/2012 - 10/2014
American Woodmark - Orlando, FloridaBusiness Analyst
  • Reviewed incoming measured and processed field orders from Field Supervisors.
  • Troubleshooting for new Encore system.
  • Collected updated documentation as needed to properly build order in Encore.
  • Reported any discrepancies to management and building service representatives.
  • Balanced scorecards on purchase orders/ran reports Built and collect documentation as needed to properly complete the order in Encore.
  • Entered cabinets and parts through data entry.
  • Trained new employees/ reported back to management.
08/2012 - 12/2012
Orlando Dental & Implant Studio - Orlando, FloridaAdministrative Associate Intern
  • Scanned and filed all patient information.
  • Entered new patients in the system.
  • Greeted and seated all patients.
  • Observed dentist while he conducted crowns, fillings, and impressions.
  • Scheduled follow up visits and discussed treatment plans for patients with long term conditions.
  • Assisted supervisor with hiring new candidates.
  • Assisted scheduling of employees.
  • Assisted in payroll.
01/2011 - 01/2012
Orchid Medical - Orlando, FloridaIntake Specialist/ Receptionist
  • Intake role, consisted of placing orders for adjusters, vendors, and for workers compensation claims, as well as calling medical offices to obtain prescriptions and adjuster information.
  • Assisted with travel arrangements for executive staff.
  • Handled incoming and outgoing calls to various personnel.
  • Distributed incoming mail and send outgoing mail to the postal office.
  • Organized and distribute files from the virtual fax.
  • Housekeeping.
01/2009 - 07/2011
University of Central Florida Parking Services - Orlando, FloridaCustomer Service Representative
  • Customer service representative of UCF for faculty, staff and students.
  • Distributed permits and collected funds for tickets and permits.
  • Customer database and information management.
  • Customer complaint resolution processing.
  • General clerk and cashier duties and operations.
  • Assisted guests, students, and faculty in regard to collection of citations.
01/2008 - 01/2009
Florida Hospital - Orlando, FloridaMedical Inventory Specialist
  • Medication inventory management of new and current products.
  • Medication measurement and labeling training.
  • Pharmacist task assistance.
Education and Training
2016
National UniversitySan Diego, CAMasters: Management Information Systems

Specialization in Systems analysis

2012
University of Central FloridaSan Diego, FloridaBachelor of Science: Health Services Administration

Minor in Health Sciences

2011
Valencia Community CollegeOrlando, FloridaAssociate of Arts
Skills

Benefits, Business Process, Cashier, CPR, Customer complaint resolution, Clients, Customer service, data analysis, data entry, Data Processing, database, dentist, documentation, fax, funds, hiring, insurance, inventory management, Access, Excel, mail, office, Outlook, Powerpoint, Microsoft Word, Networks, nursing, payroll, personnel, Phlebotomy, quality, QA, scheduling, SQL, Troubleshooting, 60 WPM, Unix, validation.

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DISCLAIMER

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

Resume Overview

Companies Worked For:

  • Medimpact Healthcare Systems
  • Sharp Healthcare
  • American Woodmark
  • Orlando Dental & Implant Studio
  • Orchid Medical
  • University of Central Florida Parking Services
  • Florida Hospital

School Attended

  • National University
  • University of Central Florida
  • Valencia Community College

Job Titles Held:

  • Pharmacy Benefits Management
  • Business Services Representative
  • Business Analyst
  • Administrative Associate Intern
  • Intake Specialist/ Receptionist
  • Customer Service Representative
  • Medical Inventory Specialist

Degrees

  • Masters : Management Information Systems
    Bachelor of Science : Health Services Administration
    Associate of Arts

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