Pharmacy Liaison with 5 years of mail order pharmacy experience. Self-starter with extensive knowledge of Medicaid and Medicare procedures. Example - Gap phase/doughnut hole.
Enthusiastic with a track record of maintaining positive relationships with customers, pharmaceutical representatives, manufacturers, medical professionals, healthcare organizations and insurance providers.
Excellent data entry skills and telephone etiquette. Detail-oriented and focused on accuracy and efficiency.
Flexible in quickly mastering new technologies and information systems.
Energetic and enthusiastic motivated to succeed in a fast-paced and professional environment. Comprehensive knowledge of Prior Authorizations/Step Therapy forms.
Excelling at working with individuals from diverse cultural and socioeconomic backgrounds. Personable and resolution-focused.
Worked at Pharmaceutical Technologies Inc. for 5 years. This company that had three departments, Insurance benefits department, Clinical department and Mail order pharmacy department. We were in the same building and I worked with each department.
Our company's website was set up, so I could assist the CSR at NPS (National Pharmaceutical Services) by looking in NPS's console to see if a insurance claim was rejected, because either the patients group or our Clinical department required a Prior Authorization or a Step Therapy form to be filled out, or if the claim needed a quantity reviewed. Waited to see if the form was accepted so the pharmacy could process the drug through patients insurance, or rejected, where I would contact the patient and let them know we are unable to fill their request.
Contact patients if their Adjuster, Group or Clinical denied their claims.
Assisted new CSR if the patients co-pays from patients plan was a percentage or a flat co-pay rate, and if their group would allow a 90 day supply from our mail order pharmacy. If not they would have to go to their local pharmacy.
Up to date on FDA new guidelines - example - No one over age 64 should be taking Citalopram 60mg. Ambiem/Zolpidem can no longer be over 10mg. ect.
Had hippa refresher courses twice a year, which required a lot of research on our part.
Entered new patient profiles into our software system.
Communicated directly with doctors' offices via telephone, fax and emails.
Provided friendly customer service.
Worked closely with pharmacists.
Efficiently answered multi-line phone and processed high volume
of order requests from patients, doctors, csr's and other pharmacy's.
Answered and screened phone calls for the staff pharmacist in a friendly, efficient manner.
Routinely operated the computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Verified patient data and billing information.
Verified accuracy and completeness of information on prescription and refill requests.
Correctly priced and filed prescriptions after they were filled.
Strictly maintained customer and patient confidentiality.
Promptly referred all doctors' calls and customers' medical questions to the pharmacist on duty.
Communicated with all customers and staff in a pleasant and professional manner.
Maintained updated records such as pharmacy files, patient profiles, charge system files and controlled drug registries.
Advised customers on the selection of medication brands. Formulary or Non-Formulary.
Consistently upheld proper pharmacy and general safety procedures and standards.
Was attending college for medical coding and administrative assistant. Only attended three years, taking general studies at that time. Was working two jobs while going to school, could only take 1-2 classes per semester.
Include volunteer work at my church and other associations, but try to downplay the association unless it's specifically related to the position. As a general rule, stress your skills, not your beliefs.
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