Driven graduate offering advanced knowledge in Pharmacy Vendor Management, Pharmacy, Hepatitis, Synagis, and Medical injectable claims to add value to a dynamic team. Proven success in working within collaborative environments to drive innovation and advance research. Seeking a new opportunity to assist in driving the Johns Hopkins Healthcare LLC objectives.
Skills
Special operations capabilities
Managing activities
Providing customer support
Adjusting routes
Monitoring quality
Organizational management principles
Allocating resources
Standard operation procedures
Intervention strategies
Analyzing performance
Team member motivation
Communication and presentation
Client-focused service
Financial calculation
Project organization
Managing file systems
Building trust and rapport
HIPAA and confidentiality
Communication and direction
Creating reports
Clinical team collaboration
Inbound phone call management
Compiling data
Conducting audits
Audit oversight
Investigative skills
Compliance
Ethical
Team leadership
Attentive listening
Strategy development
Clerical skills
Electronic database research
Collecting information
Filing and data archiving
Spreadsheet management
Meticulous attention to detail
Error identification
Verifying data accuracy
Self-directed
Time management
Understands grammar
Excellent communication skills
Quality assurance
Pleasant demeanor
Insurance processing
Customer service-oriented
Negotiation
Data entry
Vendor relationships
Team building and leadership
Data management
Customer service
Problem resolution
Conflict resolution
Basic math
Planning & organizing
Analytical
Report writing
Administrative management
Scheduling and calendar management
Process development
Event coordination
Troubleshooting
Active listening
Microsoft Office
Decision-making
Program evaluation
Content management expertise
Contract development
Performance reporting
Audit coordination
Experience
11/2010 to 01/2020
Pharmacy,HEP-C,Synagis &Medical Review CoordinatorNavy Federal Credit Union – Accokeek, MD,
Communicated with physician offices for billing purposes.
Maintained lines of communication with Pharmacies and Physician offices, providing instructions and general support.
Assessed safety procedures and Federal regulations to maintain pharmacy compliance.
Communicated with patients with compassion while keeping medical information private..
Performed routine quality assurance audits to ensure data integrity.
Audited prior authorization forms and diagnosis codes for accuracy and completion..
Reviewed medical records to meet insurance company requirements.
Reviewed account information to confirm patient and insurance information is accurate and complete.
Kept operations in full compliance with DHMH, requirements.
Applied HIPAA Privacy and Security Regulations while handling patient information.
Kept accounts current by utilizing DHMH reporting and analysis strategies.
Researched and rectified account discrepancies.
Performed with precision by entering data accurately and researching to resolve questions.
Reviewed all claims for accurateness and appropriateness.
Contacted providers to verify correct insurance information and obtain authorization for proper billing codes.
Performed insurance verification, and pre-authorization.
Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
Used MSR,MC400,Aerial and Health Suite to input claim, prior authorization and other important medical data into the system.
Explained daily processes and procedures to new hires, promoting better understanding of job tasks.
Updated spreadsheets and other document filing systems.
05/2003 to 11/2010
Pharmacy Technician/Assistant Front End ManagerRite Aid – City, STATE,
Translated management directives into actionable mandates for front-line staff.
Improved operational efficiencies, managing work requests, new orders, pricing and changes while coordinating logistics to verify delivery dates.
Distributed company correspondence, including memos and updates to reinforce and apprise departments and divisions of corporate objectives and developments.
Trained 20 employees on best practices and protocol while managing teams to ensure optimal productivity.
Recruited and hired highly talented individuals who brought Leadership and Integrity to department, which increased efficiency of entire team.
Prepared departmental budgets, analyzing of historical data, projected spending and actualized costs.
Evaluated employee job performance and motivated staff to improve productivity.
Maintained files and records for many clients and observed all safety protocols to prevent breaches and misuse of data.
Oversaw training and daily performance of 20 staff.
Produced professional and error-free letters, presentations and spreadsheets.
Handled supply purchases and inventory management for office operations and equipment maintenance.
Monitored office inventory to maintain adequate supply levels and order products.
Monitored financial bookkeeping for accuracy and compliance, resolving identified discrepancies.
Recruited, trained and developed dynamic administrative team, supporting all corporate growth and productivity objectives.
Automated office operations to manage client correspondence, record tracking and data communications.
Administered medications as per pharmacist orders.
Filled and processed prescriptions to ensure prompt and efficient patient care.
Communicated with insurance companies for billing purposes.
Communicated extensively with patients to provide assistance, support and instructions.
Efficiently responded voicemails to promote assistance and service to customers.
Restocked shelves and prepared expired drugs for return.
Inspected medication storage locations to monitor drug expiration dates and ensure adequate supply inventory.
Ordered medicines on daily basis to meet anticipated demand from patients and reduce backorder's.
Verified labeled prescriptions using 8-point check system to maintain accuracy and efficiency.
Consulted with customers via telephone or in-person to assist with navigating pharmacy systems and completing requests.
Researched customer health insurance plans to provide prescription authorization and efficient patient care.
Improved drug inventory management procedures to reduce waste and eliminate backorders or overstock.
Assisted pharmacist with clearing high volume of problem prescriptions and customer questions to maintain optimal team efficiency.
Prepared prescription transfer requests from competitor companies.
Entered orders into the system and filled medication orders.
Placed orders for out of stock medications to ensure patients received their prescriptions on time.
Ordered medicines daily to ensure compliance with demands and needs.
Created new customer profiles and updated changes such as demographics, allergies, and new medications in pharmacy computer systems.
01/2020 to Current
Vendor Management SpecialistJohns Hopkins HealthCare LLC – City, STATE,
Updated records, processed documentation and prepared timely and accurate reports.
Performed annual reviews of vendor activities, policies and procedures.
Evaluated vendor services and activities against company standards.
Identified opportunities to improve processes, reduce redundancies and decrease vendor pricing.
Filed and maintained vendor records in accordance with established guidelines.
Managed complex and important vendor agreements and relationships across multiple commodities.
Coached team on company policies, procedures and best practices to enhance operational efficiency and employee productivity.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Prioritized and organized tasks to efficiently accomplish service goals.
Present and prepare regulatory reports for NCQA, Delmarva and MDH.
Maintained and processed COB issues.
Prepare files for NCQA, Delmarva and MDH audits.
Maintain member and provider website for 4 different lines of business.
Maintain pharmacy denial and approval letters.
Education and Training
Expected in 09/2019 to to
Master of Science: HealthCare Administration Management University of Phoenix - Tempe, AZ GPA:
Certifications
Certified Pharmacy Technician (CPhT) 2003 - Current
In good standing with the Maryland Board of Pharmacy
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