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Pharmacy Technician Reimbursement Analyst

Location:
Los Angeles, CA
Salary:
25.00
Posted:
April 25, 2024

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Resume:

CARLA GONZALEZ

**** ********* **, ********, ** **552

Phone: 661-***-****

Email: ad49v6@r.postjobfree.com

Objective

Ready to apply my skills and experience to a new and challenging workplace. Ability Summary

Experienced Bilingual Pharmacy Technician with 16 years of working experience in a retail setting, 1.5 years as a Medicare Program Pharmacy Specialist, and 1.5 years as a Reimbursement Analyst for Cardinal Health/Olive View UCLA Medical Center. 28 years of excellent customer service and communication skills. Proficient in Windows OS and adaptable to MAC OS. Great at multitasking and willing to take on any task required of me. Fluent in Spanish. Typing speed at 70 WPM.

· Office team culture

· Time management

· Microsoft Excel/Word/PDF/Outlook/Microsoft

Teams/Jabber/EPS/MedHok/MedData/Powerchart/ Orchid/Etreby

· Internal Audits

· Strong analytical skills and willingness to learn

· High level of attention to detail

· Able to work independently and solve discrepancies

· Networking

· Strong written and verbal communication

Employment History

5/2022-1/2024

Reimbursement Analyst

Cardinal Health/Olive View UCLA Medical Center, Sylmar, CA

· Evaluate data input schedules from facilities in order to receive PAP medication in a timely manner

· Identify advocacy opportunities as it pertains to patient specific insurance status

· Discuss medication reimbursement with pharmacy/physician and patient based on accessibility and availability (outpatient environment)

· Initiate and process applications for advocacy opportunities for qualifying patients

· Extensive contact with manufacturers to include speaking to representatives for benefit investigation as well as inventory

· Inputing data in ledger to ensure 98-100% reimbursement recovery accuracy

· Identify and resolve rejected PAP applications

· Manage the drug recovery application process

· Maintain daily accounting activities and prior authorization documentation for qualifing patients

· Maintain security and confidentiality of patient information at all times

· Demonstrates extensive knowledge and understanding of relevant clinical out-patient procedure

· Assist internal team members regarding best demonstrated practices 07/2020 - 10/2021

Medicare Program Pharmacy Specialist, Pharmacy Technicians Inland Empire Health Plan, Rancho Cucamonga, CA (Remote)

· Coverage Determinations on Medicare prescription cases

· Communicating with health care providers

· Care Management

· Contacting Members on approved or denied cases

· Ensuring adherence to CMS, DMHC, and DHCS regulatory standards

· Assisting pharmacies with processing claims

11/2018 - 04/2020

Senior Pharmacy Technician

Sav-on Pharmacy, Tehachapi, CA

· Pharmacy Recovery

· Scheduler

· Inner store inventory management

· Staff training

· Daily Pharmacy tasks

03/2017 - 10/2018

Regional Corporate Enterprise Pharmacy System Trainer and Floater Pharmacy Techician

Sav-on Pharmacy/Safeway, Kern County, Southern California, and Central Coast Corporate

· Troubleshooting hardware and software issues for EPS conversion

· Training and assisting Pharmacy staff

· Working with DPM on/off site during conversion, inventory, internal audits, etc.

· Responsible for AMEX corporate card traveling expense reports 05/2015 - 03/2017

Pharmacy Technician, Pharmacy Technicians

Sav-on Pharmacy, Palmdale, CA

· Aiding in the transition of ARX to EPS prior to going live

· Ordering supplies and medication daily

· Responsible for inner store medication transfers (Supply Logix)

· Pulling and shipping expired medication monthly

03/2013 - 05/2015

Pharmacy Technician

CVS Pharmacy, Palmdale, CA

· Processing RX scripts

· Filing hardcopies numerically

· Filling and adjusting on hand quanties

· Dispensing medication in store and drive-thru

· Inventory management

· Shipping expired prescription medication

· Training new associates

08/2010 - 03/2013

Pharmacy Technician

Walgreen's Pharmacy, Palmdale, CA

· Prescription processing and filling

· Drug inventory and supply ordering

· Insurance billing, prior authorizations, TARS, SARS, etc.

· Communicating with third party representatives

· Helping patients with pharmacy related issues

05/2004 - 08/2010

Pharmacy Clerk/Pharmacy Technicians

Savon Pharmacy, Palmdale, CA

· Maintaining pharmacy clean and organized

· Ringing up and dispensing medication

· Assisting with inventory control and ordering

· Processing and billing insurance claims

· Filling and processing scripts

· Shipping expired medication

· Entering on hand counts in C2 folder

· Communicating with health care providers

Education History

Occupational Licenses, Certificates and Training

10/2007 - 10/2024 Pharmacy Technician

California State Board of Pharmacy

08/2001-present Antelope Valley College

Some college (Nursing)

Desired Occupation

Pharmacy/Medical adminstrative position (remote or hybrid preferred) Desired Salary

$30.00 hourly or more

Desired Job Location

Los Angeles County

Days : Sun, Mon, Tue, Wed, Thu, Fri, Sat

Shifts : Day, Evening/Swing, Night/Graveyard, Rotating, Split Employment Type : Regular or Salary

Full or Part Time : FT or PT



Contact this candidate