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Customer Service Prior Authorizations

Location:
Arizona
Posted:
February 26, 2024

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Resume:

BRITTANY MOODY

**** * ******* **** **** Apt *** Scottsdale AZ 85251 · 480-***-****

ad3xjz@r.postjobfree.com

A gregarious and hardworking employee with a desire to help people be well and stay healthy.

EXPERIENCE

JUNE 2018 – FEBRUARY 2024

PRIOR AUTHORIZATION, CPHT, SENIOR REP

CVS CAREMARK @ CVS HEALTH, INC

Accepted inbound calls to initiate requests for prior authorizations. Provided timely customer service so as to execute pertinent criteria concisely. Achieved and maintained an average handle time below the desired goal. Increased overall work speed to be able to complete incoming fax requests in an accurate and quick manner. Interacted with callers in an upbeat and cheerful manner, while maintaining professionalism and decorum. Work on a quarterly department newsletter, to keep the department engaged with each other. Assisted as a SME in training classes for incoming new hires. Took over overnight duties, to include checking the overnight voicemail and returning MDO calls received via voicemail, as well as completion of the New York OBC queue and other offline duties. Assisted with researching reported errors and coaching the reps regarding the errors they received. Previously worked as a Supervisor, in charge of a team of mostly new hire reps. Coach via one on one with reps, as well as attending meetings with other supervisors and managers to assist with queue management and other tasks. Elected to transition to a new role as a Senior Representative, assisting new hire reps to assist with completing prior authorizations, research rejections and write/edit overrides that allow for the coverage of a member’s medications. Multitask efficiently and effectively to complete all duties and tasks in an orderly and timely fashion. NOVEMBER 2017 – JUNE 2018

PRIOR AUTHORIZATION, CPHT, CONTRACTOR,

CVS HEALTH VIA THE CSI COMPANIES

Accepted inbound calls to initiate requests for prior authorizations. Provided timely customer service so as to execute pertinent criteria concisely. Achieved and maintained an average handle time below the desired goal. Increased overall work speed to be able to complete incoming fax requests in an accurate and quick manner. Interacted with callers in an upbeat and cheerful manner, while maintaining professionalism and decorum.

MAY 2017 – OCTOBER 2017

PHARMACY RESOURCE CENTER OUTREACH TECHNICIAN, CONTRACTOR, PRIME THERAPEUTICS VIA THE CSI COMPANIES

Assist members in reaching out to their prescribers for new medications. Provide a liaison between members and their doctors, to resolve concerns regarding unattained prescriptions. Fulfilled job tasks in various queues to assist in the flow of work for the pharmacy. Performed outbound calls to physicians’ offices to resolve outstanding requests. Assisted in delivery of incoming media to data entry for typing and adjudication. AUGUST 2012 – DECEMBER 2017

SENIOR PHARMACY TECHNICIAN,

WALGREENS BOOTS ALLIANCE COMPANIES

Fulfill orders for patient quickly and efficiently. Perform data entry tasks accurately for pharmacist verification. Organize and plan flu clinics for pharmacy compliance. Manage all incoming and outgoing paperwork, as needed. Perform outbound calls to physician’s offices to assist patient in receiving new prescriptions, certificates of medical necessity (CMN paperwork), and prior authorizations. Reach out to insurance companies to resolve adjudication issues and other third party rejects. Log and scan all incoming shipments, as well as put up medication after scan was complete. EDUCATION

JULY 2021

BACHELORS OF ARTS, CREATIVE WRITING WITH FOCUS IN

FICTION

SOUTHERN NEW HAMPSHIRE UNIVERSITY

Earned bachelor’s degree from Southern New Hampshire University, through online program. Majored in Creative Writing with a focus in Fiction. Minored in European History. Inducted into two Academic Honors societies during time at the university – Sigma Tau Delta and The National Society of Leadership and Success. Achieved a GPA of 3.24 during the course of study. MAY 2004

ASSOCIATES OF LIBERAL ARTS WITH SPECIAL REQUIREMENTS, MESA COMMUNITY COLLEGE

Earned two associates degrees within the course of two years, with focuses in History and English Literature. Inducted into the Phi Theta Kappa honors fraternity during the course of study. Graduated with an Honor’s Degree, awarded for my major of History. Achieved a GPA of 3.64 over the course of my study.

MAY 2004

ASSOCIATES OF GENERAL STUDIES,

MESA COMMUNITY COLLEGE

Earned two associates degrees within the course of two years, with focuses in History and English Literature. Inducted into the Phi Theta Kappa honors 2

fraternity during the course of study. Graduated with an Honor’s Degree, awarded for my major of History. Achieved a GPA of 3.64 over the course of my study.

SKILLS

● 116 words a minute at last test

● Personable and Gregarious

● Patient and Accommodating

● Self-Confident

● Hard Working and Reliable

● Proficient with Microsoft Office Suite:

Word, Excel, PowerPoint, Outlook

● Proficient with Tableau, CAS, CAS Admin,

Sharepoint, SalesForce and

RXClaims/AS400

ACTIVITIES

Achieved a 5 Year Pin while working for Walgreens Boots Alliance Companies, as a Senior Pharmacy Technician in their retail stores. Worked retail pharmacy for many different companies, totaling 15 years in the retail pharmacy environment. Highly proficient in both written and spoken English, with a large vocabulary in both. Minimal fluency in both Spanish and American Sign Language. Member of Pi Theta Kappa, Sigma Tau Delta and the National Society of Leadership and Success, all three of which are Academic Honors Societies. Published poetry and short stories in several college and high school publications, as well as hosting published work in a HUGO Award winning online database. 3



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