Pharmacy Benefits Management Resume Example
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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
|
Technical Skills
| Skills | Experience | Total Years | Last Used | |||
|---|---|---|---|---|---|---|
| SQL |
Accomplishments
- Certifications:.
Basic Life Support
Phlebotomy
Work Experience
01/2015 - Current
First Citizens Bank － Vienna , VAPharmacy 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
Foot Locker － Plantation , FLBusiness 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
Hopkins Manufacturing Corp. － Arlington Heights , ILBusiness 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 － City , STATEAdministrative 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 － City , STATEIntake 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 － City , STATECustomer 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 － City , STATEMedical Inventory Specialist
- Medication inventory management of new and current products.
- Medication measurement and labeling training.
- Pharmacist task assistance.
Education and Training
2016
National UniversityCity, StateMasters: Management Information Systems
Specialization in Systems analysis
2012
University of Central FloridaCity, StateBachelor of Science: Health Services Administration
Minor in Health Sciences
2011
Valencia Community CollegeCity, StateAssociate 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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Resume Overview
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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