PHARMACY COORDINATOR Resume Example
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PHARMACY COORDINATOR
Professional Summary
- Seeking a position in HEALTH CARE SERVICES as a PATIENT AUTHORIZATION REPRESENTATIVE where my continuing education, years of experience and professional training as a PHARMACY TECHNICIAN/PRIOR AUTHORIZATION COORDINATOR will be effectively utilized to provide comprehensive services and direct client care. Also seeking to advance within a company and take on more responsibilities as I gain necessary knowledge. Licenses In good standing with the California State Board of Pharmacy-Pharmacy Technician TCH 81163 In good standing with the National Pharmacy Technician Certification Board as a Certified Pharmacy Technician (CPhT) Certification Number 10064132 Skill Highlights
- Eight years of successful career experience as a retail Pharmacy Technician with major emphasis on direct customer service, obtaining and properly dispensing prescription orders
- Comprehensive academic and clinical experience in terminology, nutrition, pharmaceutical calculations, medication usage and distribution
- Four years experience in prior authorization review, maintain expert knowledge on all Medicare Pharmacy benefits and formularies, including Centers for Medicare Services (CMS) regulations as it pertains tothis position
- Strong computer skills and working knowledge of Microsoft products, claims processing software with the ability to learn new software applications
- Effective liaison who maintains reliable professional connections between the health care company and its associates
- Provide accurate quality checks on active prior authorization claims while working within the guide lines and policies of the company
- Articulate, confident and knowledgeable communications with physicians, medical staff/assistants and insurance/worker compensation agents supported by accurate documentation and time management skills
- Professional understanding of Medicare processing and HIPAA guidelines
Work History
PHARMACY COORDINATOR, 03/2019 to Current
Baptist Health South Florida – Boca Raton , FL
Baptist Health South Florida – Boca Raton , FL
- Analyze and summarize data to support and develop efficient workflow operations.
- Perform wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
- Understand and execute principles of Prior Authorization to facilitate appropriate prescription needs of patients.
- Perform effective communication with Line of Business (LOB) representatives including, but not limited to, Commercial, Medicare and Medi-Cal insurance to verify patients' health plan eligibility.
- Established professional knowledge of DOFR (Division of Financial Responsibility).
Pharmacy Technician, 11/2014 to 04/2018
Assistrx – Philadelphia , PA
Assistrx – Philadelphia , PA
- Demonstrated professional knowledge of DOFR (Division of Financial Responsibility).
- Performed Medicare Part D and Commercial HMO/POS Prior Authorizations.
- Assisted members services daily with pharmacy claim issues and inquiries using appropriate references for accurate resolutions.
- Conducted pharmacy claims corrections and performed quality checks on active prior authorization claims when necessary.
- Provided professional assistance to medical offices and pharmacies pertaining to prescription benefit inquiries.
- Reviewed requests made by physicians and pharmacies for use of prescription drugs that are non-formulary and determine appropriate outcome.
- Answered phone calls for prior authorization inquiries.
- Assigned, entered and documented prior authorizations into appropriate claims processing system.
Pharmacy Technician, 01/2008 to 06/2015
Assistrx – Albuquerque , NM
Assistrx – Albuquerque , NM
- Provided assistance, support and drugstore management with pharmacists, and conducted continuous professional customer service.
- Daily duties included but not limited to, counting, packaging, labeling and properly dispensing medications.
- Performed follow up calls to physicians, insurance agents and worker compensation claims to verify refills and prescription approvals.
- Obtained and processed medication refill orders by telephone and fax.
- Filled prescriptions, managed supply orders and inventory.
- Referred customers for prescription consultations if required.
- Completed Medi-Cal Treatment Authorization Request (TAR 50-1) forms.
- Strictly maintained customer and patient confidentiality with knowledge in compliance with Health Insurance Privacy and Portability Act (HIPPA) guidelines.
Pharmacy Technician, 01/2014 to 05/2014
Assistrx – Boston , MA
Assistrx – Boston , MA
- Input and document PA request determination.
- Notified physicians/providers and members (when necessary) of PA request determination.
- Communicated routinely with client health plans to assist with PA entry.
- Maintained Prior Authorization documents, databases and records.
- Participating member of Pharmacy Services Team, ensuring that all documentation was completed accurately, on time and within HIPAA requirements.
- Received incoming prior authorization (PA) requests via phone or facsimile from physicians/providers.
- Established professional, continuous communications with physicians/providers via phone or facsimile when additional information was required.
- Held requests for further review pending receipt of requested information from providers/physicians.
Education
Certificate Program: Certified Pharmacy Technician: 2014
California State Dominguez Hills - City, State
California State Dominguez Hills - City, State
DIPLOMA: PHARMACY TECHNICIAN, 2008
Everest College - City, State
Everest College - City, State
HIGH SCHOOL DIPLOMA: 2005
John Muir High School - City, State
John Muir High School - City, State
Highlights
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Resume Overview
School Attended
- California State Dominguez Hills
- Everest College
- John Muir High School
Job Titles Held:
- PHARMACY COORDINATOR
- Pharmacy Technician
Degrees
- Certificate Program: Certified Pharmacy Technician : 2014
DIPLOMA : PHARMACY TECHNICIAN , 2008
HIGH SCHOOL DIPLOMA : 2005
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