SEARCH

Pharmacy Benefits Management Resume Example

Resume Score: 90%

Love this resume? Build Your Own Now
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
Skills Experience Total Years Last Used
SQL
Accomplishments
  • Certifications:.

Basic Life Support

Phlebotomy

Work Experience
01/2015 - Current
Medimpact Healthcare Systems － San Diego, CA Pharmacy 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, California Business 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, Florida Business 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, Florida Administrative 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, Florida Intake 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, Florida Customer 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, Florida Medical Inventory Specialist
  • Medication inventory management of new and current products.
  • Medication measurement and labeling training.
  • Pharmacist task assistance.
Education and Training
2016
National University San Diego, CA Masters: Management Information Systems

Specialization in Systems analysis

2012
University of Central Florida San Diego, Florida Bachelor of Science: Health Services Administration

Minor in Health Sciences
2011
Valencia Community College Orlando, Florida Associate 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.

Build Your Own Now

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

Advertisement

Similar Resumes

View All

Assistant Portfolio Benefits Management

Absa Bank Ltd

Silverton, Texas

Posted 1154 days ago