Data Entry Pharmacy Technician/Qa specialist

AMBER AYE

Mobile: 214-***-**** / Email: ***********@*****.***

CORE STRENGTHS

Customer-Service Skills Pharmacy Benefits Management (PBM)

Medication Pharmacology Knowledge Pharmaceutical Calculations

Detail Oriented and Accuracy Interpersonal Skills

Organizational Skills Leadership/Management Skills

Prior Authorizations in healthcare Stress Management

Empathetic Communication

Inventory Control

Collaboration and Teamwork

Problem Solving

PROFESSIONAL EXPERIENCE

PREMIER MANAGEMENT & REVIEW SOLUTIONS (PM&R SOLUTIONS), Port Saint Lucie, FL Peer Review services to Workers Compensation, Group Health, Pharmacy, Disability, and Auto Liability insurance carriers Quality Assurance Specialist: November 2022 – present (Remote)

Assures that programs and services are implemented to the highest standards and that patients receive the highest level of care by providing consultation and direction in medication pharmacology.

Summarize medical records for treating providers for worker's compensation litigation, including disability and leave, accident and health, casualty, and liability, as well as data and analytics.

Ensures that policies and procedures are monitored and modified to reflect changes in regulatory requirements. Operations Supervisor: October 2014 – November 2021 (Remote)

Administered complex problems and executed complex transactions for client’s and workman compensation adjusters, including utilization, disability, and pharmaceutical evaluations with the claimant’s treatment providers.

Participated in research, design, development and implementation of complex products, systems, and services in an operation’s environment.

Organized projects, audits, and direct team related activities and special initiatives.

Mentored employee relationships and trained on-boarding new hires.

Build reputation as key player for leading by example and helping others accomplish their desired plans and goals.

Dedicated to exceeding internal and external customer expectations. WALGREENS, SACRAMENTO, CA

Walgreens is the second-largest pharmacy store chain in the U.S. Specializes in filling prescriptions, health and wellness products, health information, and photo service.

Insurance Coordinator: March 2014 – April 2014

Oversaw responsibility for assuring compliance with third-party payers and submitting prior authorization requests when necessary.

Act as a liaison between the pharmacy, the hospital, and insurance companies, and advocates for the patient to guarantee receipt of benefits and coordination of care.

DANE STREET, WALNUT CREEK, CA

National Provider of IME and Medical Peer Review Services Customer Service Representative II/Pharmacy Team Lead: January 2013 – February 2014

Assisted the client and worker’s compensation adjusters in conducting utilization evaluations with the claimant’s treating providers.

In addition to daily correspondence with the adjusters, tasks included contacting physicians, data entry, proofreading, and general administration.

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SUTTER HEALTH, BURLINGAME, CA

Sutter Health is a not-for-profit integrated health delivery system Temporary Pharmacy Technician: October 2012 – December 2012

Pioneered and supported the software deployment for the transfer of patient records and medications from NextGen to Epic software and data entry.

OMNICARE PHARMACY, HAYWARD, CA

Pharmacy specializing in nursing homes. Acquired by CVS Health Temporary Pharmacy Technician: September 2012

Assisted Pharmacist in receiving, preparing, and packaging prescriptions orders for dispensing as well as in managing drug and medical supplies.

Systematized medication and supply inventories, including stock level review and recording order data.

Communicated with customers, gathered clinical information, and addressed non-medical questions and concerns. US SCRIPT, FRESNO, CA

Pharmaceutical Manufacturing

Temporary Prior Authorization Triage Specialist/PBM: February 2012 – August 2012

Used the prior authorization criteria offered by managed care organizations or commercial institutions to prioritize prior authorization requests.

Input and document prior authorization request determination (i.e., approval or denial) into PBM systems, and notify physicians, providers, and members, as needed, of prior authorization request determination. EDUCATION

Lake Tahoe Community College, Lake Tahoe, CA

California State Board of Pharmacy, Certificate – Licensed Pharmacy Technician Pima Medical Institute, Mesa, AZ

TRAINING/SEMINARS

.

Pharmacology

Pharmacy Practices

Dosage Calculation

Medical Terminology

TECHNICAL SKILLS

Storenet/Walgreens AS400 Rumba

Stellant Imaging Irx/Jwalk

SXC/Echo CPR+

Epic/NextGen Software Microsoft Office 365: (Outlook, OneNote, Windows 10, Word, Excel, PowerPoint, and Access)

Quickbase Cloud Database PRS Software/Broadspire

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