Tia Lopez

*** ********* ******, ********** **, Email: acfa14@r.postjobfree.com Phone: 724-***-****

Experience Highlights

Customer Service, Reception & Nursing Skills

• Experienced, detail-oriented, systematic and confident professional with a background in

multimedia, healthcare customer service and marketing.

• Proven self-starter with exceptional leadership skills and ability to overcome challenges.

Confirmed ability to take ideas from conception to completion. Creative and methodical

management, organizational, and communication skills.

Software Skills/Additional Skills

• Adobe Photoshop

• Adobe Illustrator

• Adobe Premiere

• Macro media Flash

• Macro media Director

• Microsoft Word, Excel, Power Point and Spreadsheet

• ICD-9 and ICD-10 Coding

• Medical Claims and Billing

Employment History

CVS Caremark 12/2013-Present

Medicare Part D Representative

• Review prior authorizations faxed into a program called Medhok, complete client profile and

process accordingly.

• Review formulary and non-formulary drugs for accept or denial depending on the insurance from

private pay or commercial businesses.

• Call doctor’s office to verify information on fax is correct. Also check information in AS400 and

Peoplesafe for accuracy

• Review completed information before submitting to secondary for review.

Tia Lopez

601 Minnesota Street, Pittsburgh Pa, Email: acfa14@r.postjobfree.com Phone: 724-***-****

• Running test claims to see if the claims reject or pay

• Making outbound calls to doctors offices to acquire additional information for medication request

The Commons of Squirrel Hill, 02/2013-09/2013

Certified Nurse Assistant, Pittsburgh PA

• Assist with helping elderly by dressing, feeding, and cleaning their living space.

• Completed charts every hour for medication taken, and activities done throughout the day

• Maintain cleanliness within the work area for next shift.

UPMC Worksource, 10/2012-12/2012

Customer Service Rep, (temp) Pittsburgh PA

• Verified insurance coverage for Medicaid clients

• Assist with client information for best quality for Medicaid clients,

• Monitored close detail for Medicaid insurance for proper paying solution

Walgreens Specialty Pharmacy, 03/2012- 09/2012

Insurance Verifier (temp), Pittsburgh PA,

• Completing accurate research for specific client with the computer program of choice.

• Following strict instructions for HIPPA cases, verified date of birth for client.

• Completed necessary calls to specified physicians for transaction approvals.

Additional Experience Page 2

CVS Caremark (CSI Companies) 05/2011- 07/2011 (Temp assignment)

Account Representative (Prior Authorization with Insurance Benefits), Pittsburgh PA

• Verifying information in Peoplesafe, for accurate client information and current

insurance verification

• Maintained HIPPA privacy while assisting with client on via telephone

• Completed statement from call into client profile

• Verified complicated information to supervisor when unable to complete specific

task.

Tia Lopez

601 Minnesota Street, Pittsburgh Pa, Email: acfa14@r.postjobfree.com Phone: 724-***-****

Aetna Inc., 08/2009-12/2009

Customer Service Representative (temp), Pittsburgh PA

• Providing high quality customer service and satisfaction to clients

• Answered questions and resolved problems for clients in relation to their medical

plans.

• Completed office requirements for accurate reports for cliental purposes.

Education

University of Pittsburgh, Pittsburgh, PA

• Master’s Degree, Major: Health Information Systems, January 2016

Point Park University, Pittsburgh, PA

• Bachelor of Science, Major: Integrated Marketing Communications, August 2009

• Relevant Coursework: Strategies of Marketing, Psychology of Negotiation, Marketing

Research

ITT Technical Institute, Pittsburgh, PA

• Associate of Information Technology in Multimedia, December 2006

• Relevant Coursework: Broadcasting, Animation 1& 2, Web Designing for HTML & Java

Reference Available Upon Request

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