Bibi F. Khan, MBCS

Cell: 201-***-****

Email: ad38vr@r.postjobfree.com

Skills US PQC, PTC, FDA, GMID, LMID, GPV, Siebel (ACES), Trackwise, NICE, 21 CFR820, 803, ISO 13485. EUMDR. Veeva Vault, Micro Merchant, Prime Rx, Comet, Pfizer Compliance Education Center (PCEC) 2019 U.S. Healthcare Laws and Regulations. Medical Communication, Global Regulatory, Managed market. SharePoint, Framework, CARS/Medi, CCRA, COGNOS, TRIM, Aravo, Model N, SAP, Opus Health Rx, Optuminsight, Caretracker EHR (Ingenix), Magellan, Allscripts, Affinity, Nextgen, QS/1, NRx, Medics Elite (ADS), Medisoft, Medical Manager, Mumms, Zirmed, Outlook, ICD-9, ICD 10. CPT-4, EOB analysis & reconciliation, Pre-cert, medical terminology and administration, A/R Management, medical billing, Orthopedic billing and coding, Posting Charges and Payments, Credentialing, Prior-authorization, Cover my Meds, HCFA-1500, HIPPA. Third party follow-up, HME, DME, HCPCS, Medicare A and B, Medicaid, Managed Care, and Blue Cross-Blue Shield. Strong data entry skills. Pharmacology, Pharmacovigilance (Drug Safety), PMQA, MDR, 21 CFR Part 11. 21 CFR Part 210, 211 & 820. MeDRA, Medwatch, 510(k) & PMA, WHODD, CAPA, GxP, cGMP, Medical Billing and Coding. Medical Records Review, Claims Analyst.

Experience

10/2023 - Current Wellpath, Hudson County Correctional Facility, NJ

Clinical Pharmacy Technician.

Accurately dispense medications as per prescriptions under the supervision of a licensed Pharmacist.

Perform a range of administrative duties as assigned by healthcare professionals, including physicians and charge nurses.

Efficiently manage and organize pharmacy inventory to ensure availability and proper storage of medications.

Responsible for the receiving, storing, and verification of pharmaceutical stock, ensuring accuracy and compliance with regulations.

Maintain effective communication with nursing staff and other healthcare team members to facilitate coordinated patient care.

Adhere to all pharmacy technician regulations and guidelines, maintaining a high standard of practice and contributing to a safe and effective pharmacy environment.

06/2023 - 07/2023 Mikes Pharmacy LLC, East Orange NJ (Contract)

Pharmacy Technician, Prior Authorization Specialist.

Review, process and troubleshoot incoming Prior Authorization requests for various medications. Use of Prime RX. Micro Merchant, Cover My Meds. Conducted Marketing and Sales, Vendor & Community Services for Greater Essex Counseling Services.

Accurately process requests according to regulatory and client specific guidelines while working with other team members to meet the departmental metrics and maintain compliance.

Work with clinical to ensure requests are processed accurately and timely via phone, fax, and web submission.

Communicate Prior Authorization criteria to providers.

Respond to and resolve all internal and external inquiries in a timely, accurate and complete manner.

Prioritize work appropriately and as assigned by leadership.

Protect all health information and abide by HIPAA regulations and confidentiality requirements.

03/2023 - 05/2023 Randolph & Main Street Pharmacy, Boonton NJ (Contract)

Pharmacy Technician, Prior Authorization Specialist.

Review, process and troubleshoot incoming Prior Authorization requests for various medications. Use of Prime RX. Micro Merchant, Cover My Meds.

Accurately process requests according to regulatory and client specific guidelines while working with other team members to meet the departmental metrics and maintain compliance.

Work with clinical to ensure requests are processed accurately and timely via phone, fax, and web submission.

Communicate Prior Authorization criteria to providers.

Respond to and resolve all internal and external inquiries in a timely, accurate and complete manner.

Prioritize work appropriately and as assigned by leadership.

Protect all health information and abide by HIPAA regulations and confidentiality requirements.

10/2022 - 11/2022 AbbVie (Consultant for Artech) Remote, Austin TX (Completed Contract)

Product Complaint Analyst I

Responsible for complaint records meeting global requirements. GxP, use of Veeva Vault.

Review Medical complaints that involve a non-medical quality related event.

Provides quality customer service through coordination of return samples for investigation, follow up activities such as replacement of product, complaint categorization and CAPA. Model N. Medical Communication. Use of NICE monitoring system. 21 CFR820, 803, ISO 13485. EUMDR.

Ensures that complaint documentation files meet Good Documentation Practices, GMP and GCP, and regulatory requirements.

Identification of potentially reportable events and create notification to appropriate functional groups and management.

Engage with Third Party Manufacturers, health care professionals, public, internal customers, AbbVie functional areas and regulatory agencies. Strong customer service.

09/2021 - 3/2022 Genpact Pharmalink Remote, Bridgewater NJ

Sanofi PQC, Analyst (Completed Contract)

Identified, confirmed, and monitored inquiries as product technical complaints and evaluates complaints for severity and risk to public safety. Use of NICE monitoring system. Customer service Representative.

Interacted with both internal and external manufacturing sites regarding technical complaints and their associated investigations. Medical Communication. 21 CFR820, 803, ISO 13485. EUMDR.

Ensured complaints and sample receipts are tracked and processed in a timely fashion.

Coordinated with complainant and reporters to attain the required details for a full complaint/case investigation. Model N product knowledge. Veeva Vault.

Trained in Federal cGMPs and FDA regulations with emphasis on complaint handling regarding medical devices, pharmaceutical products, biologics, and combination products.

Performed internal quality control for critical processes.

12/2020 – 02/2021 IQVIA Pharmaceutical Company, Remote, Raleigh, NC (Completed Contract)

08/2019 - 09/2019 Quality Assurance & Claims Analyst /Accounts Receivable / Medical Billing & Coding Associate

Performed and provided systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure quality assurance standards are met. Medical Communication Specialist.

Processed rebates & claims/collection and reconciliation for Pfizer & Novartis drug programs, customer service.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

Used Excel, Opus Health Rx System. Documentation Management, weekly and monthly billing, follow-up (claims management) in aging report. Use of NICE monitoring system.

Worked with the Accounts Receivable team to prevent deductions by the wholesaler and assist in the timely reimbursement of denied chargebacks. Managed market experience. Model N. 21 CFR820, 803, ISO 13485. EUMDR.

Followed up with insurance companies to verify eligibility coverage for drug benefits, UB04, DRG, HCFA 1500, ICD, CPT, NDC and HCPC coding.

03/2020 – 09/2020 Allergan Pharmaceutical, Remote, Madison NJ

Medical Scientific Information Analyst (Consultant, Completed Contract), Medical Communications.

Received, triaged, and processed product identification calls, including speaking with the caller, and documenting the request from the call into the Medical Information Database (IRMS). Customer service representative.

Analyzed and coordinated the transfer of any query beyond the scope of approved responses and required a peer medical information reply. Use of NICE monitoring system.

Identifies Adverse Events and Quality Complaints to triage appropriately and runs Reconciliation Reports per Compliance. Managed market experience. Model N. Veeva Vault. 21 CFR820, 803, ISO 13485. EUMDR.

Maintained updated records for Unsolicited Requests (Sales Representative/MSL)

Processed outgoing responses via database and hard copy mailings, as needed.

Coordinated Global Scientific Information requests to the appropriate medical personnel.

04/2019 – 06/2019 Partners Pharmacy, Springfield, NJ

Long Term Care Facility, Data Entry Pharmacy Technician

Generated prescriptions from triage, fills, and processed. Worked with brand and generic labelers. Answers inquiries to prescriptions and insurance billing. Adjudicating claims for RX. Inputs sigs and types of prescriptions into RX database. Use of Framework.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

Handled high volume calls and queries from vendors and patients.

Strong analytical and time management skills. Excellent verbal & written communication skills.

09/2016 – 07/2019 CVS Pharmacy, Berkeley Heights, NJ

Pharmacy Technician

Customer service, Generated prescriptions, worked with brand and generic labelers, answered inquiries to prescriptions and insurance billing, adjudicated claims for RX, and completed inventory within pharmacy controls.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

10/2016 - 11/2016 Johnson & Johnson Health Care Systems, Piscataway NJ

Medicaid Rebate Associate Analyst (contract)

Generated and processed monthly, quarterly reports and supporting documentation for State Medicaid rebates using CARS/Medi, SharePoint, Excel, and Outlook.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

12/2015 - 03/2016 Actavis /Teva, Parsippany NJ

Claims Analyst (Consultant)

Identified Brands and Generics at the facility and maintained inventory.

Processed Claims and added new products, National Drug Codes (NDC) in global database using Model N, processed rebates for Medicaid. Medical Communications. GxP. Veeva Vault.

03/2015 - 05/2015 Cegedim Dendrite Drug Company/Opus Health, Bedminster NJ (contract)

Quality Assurance Analyst/Accounts Receivable/ Medical Billing and Coding Specialist, Claims Analyst

Performed and provided a systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure that quality assurance standards were met.

Review, process and troubleshoot incoming Prior Authorization requests for various medications. Use of NICE.

Processed rebates & claims /collection and reconciliation for Alkermes Prescription drug program, using Excel, Opus Health Rx System. Prime RX, Documentation Management, weekly and monthly billing, follow-up (claims management) in aging report. Managed market experience.

Worked in concert with the Accounts Receivable team to prevent deductions by the Wholesaler and assist in the timely reimbursement of denied chargebacks.

10/2014 - 12/2014 Compassionate Care Hospice, Parsippany NJ

Collections and Claims Analyst – Documentation Management

Performed healthcare information and medical claims processing, healthcare billing and collection services, and provides financial guidance regarding hospital, HMO, clinical services to patients, their families, and third-party representatives.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

11/2013 - 09/2014 McKesson Provider Healthcare Information Technology, Somerset NJ (contract)

Quality Assurance Analyst/ Accounts Receivable/ Medical Billing and Coding Specialist,

Clinical Revenue Office Supervisor

Performed and provided a systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure that quality assurance standards were met. Customer service.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

Managed seven employees; performed healthcare information and medical claims processing, healthcare billing and collection services, and provided financial guidance regarding hospital, HMO, clinical services to patients, their families, and third-party representatives. Managed market experience.

01/2013 - 04/2013 Columbia University, NYC

Medical Billing and Coding Specialist / Patients Account Representative. Clinical Revenue Office (CRO)

Performed claims managements on patients accounts through IDX, ETM systems for Columbia, New York Presbyterian, & Cornell patients, and Grand Orthopedic and New York Orthopedic doctors. Medical Communication.

Review, process and troubleshoot incoming Prior Authorization requests for various medications.

Accessed medical records via Allscripts (Crown system) for secondary claims, Medicare, Medicaid, and various primary and secondary payer.

Entering CPT and ICD codes on corrected claims for resubmission in error

Preparing invoices for specific dates of services based upon client’s requests.

Education Allied Medical and Technical Institute, Wayne, NJ

Graduate, CPhT/ Pharmacy Technician Certification Board (PTCB)

Diploma, Medical Billing and Coding Specialist

NJ Board of Pharmacy Licensed

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