Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking entry-level opportunities to expand skills while facilitating company growth.
Skills
Understanding of medical terms
Practitioner order verification
Issue Research
Precertification requirements
Patient Health Information Access
HIPAA Compliance
Arranging Discharges
Medical Terminology
Medical Charting
Customer Service
Unit Administrative Support
Patient Billing
Cash Handling
Collaboration and Teamwork
Data Entry
Insurance Authorizations
Proper Labeling Procedures
Verifying Orders
Ordering and Stocking Medications
Answering and Routing Calls
Cash Register Operations
Payment Processing
Dispensing Medications
Patient Profile Setup
ERP Software
Detail-Oriented
Workflow Optimization
Supporting Pharmacy Operations
Insurance Billing
Resolving Customer Issues
Experience
03/2022 to Current
Prior Authorization SpecialistGila Regional Medical Center – Silver City, NM,
Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
Coordinated resolutions for issues and appealed denied authorizations.
Notified ordering providers of denied authorizations.
Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
07/2017 to 04/2022
Pharmacy TechnicianMolina Healthcare Inc. – Syracuse, NY,
Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions.
Interpreted and processed medication orders under supervision of pharmacist.
Received and verified daily incoming drug inventories, reported discrepancies and logged items into inventory system.
Refilled medications, offered insight into over-the-counter products and verified insurance benefits.
Flagged potential side effects and allergies to prescribed medications for patients.
Verified prescriptions and drug labels, documents and packages.
Maintained strict patient confidentiality to adhere to HIPAA regulations and avoid data compromises.
Maintained clean and organized pharmacy shelving and work areas.
Verified patients' identities at pickup to prevent sale of wrong medications.
Managed inventories, rotated stock, removed expired or damaged drug products and resolved discrepancies in drug counts.
Efficiently processed cash register transactions for new and refilled prescription orders.
Completed and filed patient paperwork, updating records in system with insurance carrier changes and allergy information.
Prepared prescription labels, promoting accuracy in medication administration and dosing.
Worked with insurance companies to process claims, resolve problems and obtain payments.
Established and updated patient profiles, medications and insurance details.
Consulted with customers via telephone or in-person to assist with navigating pharmacy systems and completing requests.
Educated patients on prescription instructions and answered questions regarding drug side effects.
Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
Prepared prescription transfers to other pharmacies.
Teamed with peers, technicians and pharmacists to prioritize and complete orders.
Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
07/2021 to 03/2022
Lab Processing Specialist EAST ALABAMA HEALTH – City, STATE,
Receive lab orders from physicians office
Verify patient's demographics and enter data into database
Process physicians lab orders
Verified lab orders to ensure correct test are entered for lab processing
Label specimens correctly for accurate processing
Place blood specimens in centrifuge
Transfer specimens to correct departments
Verify and bill patients insurance correctly
03/2020 to 07/2021
Personal Care Medical TechnicianEAST ALABAMA HEALTH – City, STATE,
Provided excellent patient support and care to patients and families.
Observed and recorded vital signs and reported changes to physicians or nurses.
Adhered to all safety and infection control precautions and regulations.
Supported healthcare teams in consistently delivering timely and quality care according to company standards.
Monitored patients for medical changes and reviewed and revised care plans accordingly.
Monitored medical supply inventory to ensure consistent availability of critical items.
Reported safety hazards to supervisors, removing risk and promoting workplace safety.
Protected patients and employees by adhering to infection-control and hazardous waste policies.
Collected specimens for lab testing, practicing aseptic technique to reduce risk of infection.
Communicated with patients to explain specimen collection procedures and answer questions.
Performed blood draws while offering compassionate care.
Documented and updated patient data on electronic medical charts, maintaining accuracy and confidentiality.
Education and Training
Expected in 05/2015
Certificate: Cosmetology Southern Union State Community College - Opelika, AL, GPA:
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