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Pharmacy Technician Prior Authorization

Location:
Greensboro, NC
Salary:
23/hr
Posted:
March 30, 2024

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Resume:

904-***-****

MSG

MORIAH SPECIAL GORDON ad4oe0@r.postjobfree.com

Winston-Salem,NC

PROFESSIONAL SUMMARY

Shift Lead Walgreens/Pharmacy Technician May 2021-October 2023 Jacksonville, Fl

●MTMs, Counseling patients and answering questions they may have.

●Supervise store employees and monitored machines to determine functionality.

●Implement solutions or resolve credit issues with customers.

●Manage operations during shift, with total awareness of activities of employees and customers.

●Offering guests and staff a safe environment by strictly enforcing company rules.

●Review customer play and issue complementary services to maintain customer loyalty.

●Guide staff in absence of direct supervisors.

●Maintain awareness of customer activities and good relations with high-value customers.

●Consult with the Store Manager to provide guidance on best practices and business operations.

●Continuously monitor systems like POS and Back Office to quickly identify and address their issues.

●Review accounts daily to determine the areas in need of improvement and strategies for correcting faults.

●Develop procedures and policies by devising strategies, consistently improving processes and supporting organizational goals.

●Resolve or escalate business problems to keep operations moving smoothly.

●Produce weekly reports outlining the business operations successes and gaps for the senior management team.

●Process the day-to-day documentation between departments, consistently maintaining effective communication and eliminating bottlenecks.

●Address concerns quickly to avoid lasting issues.

●Support operations with consistent maintenance and updates of corporate files and records.

●Handle deposits, money drops, counted registers and the safe

Senior Prior Authorization Pharmacy Technician Oct 2018 May 2019

Optum Jacksonville, FL

●MTMs, Counseling patients and answering questions they may have.

●Member of the MEDCO team for Medicaid patients in United Healthcare Optum

●Resolved customer issues and answered questions to deliver positive customer experience

●Processed referrals and submitted clinical supporting documentation to insurance carriers to expedite prior authorization processes

●Analyzed denials and submitted appeals to obtain approval from insurance companies

●Reviewed denials and submitted appeals to gain approval from insurance companies

●Processed referrals and submitted medical records to insurance carriers to expedite prior authorization processes

●Documented all prior authorization information in patient profiles, including approval dates and prior authorization numbers

●Reviewed accuracy and completeness of information requested and verified presence of all supporting documentation

●Managed correspondence with insurance companies, physicians, and patients as required

●Secured patients' demographics and medical information using discretion to protect privacy

●Assisted with medical necessity documentation to expedite approvals and confirm appropriate follow-up.

●Prioritized prior authorizations in alignment with expiration deadlines

●Resolved incoming calls concerning members' eligibility, benefits, provider information, monthly premium billing, clinical, and pharmacy needs

Pharmacy Technician Nov 2014 Oct 2018 Walgreens

Saint Augustine, FL

●MTMs, Counseling patients on their medications and answering any questions they may have.

●Worked in various departments throughout the store

●Filled prescriptions by retrieving, counting, and pouring pharmaceutical drugs, verifying medicine correctness and checking for possible interactions

●Helped Pharmacy department with inventory processes to provide smooth process flow and customer experiences

●Adhered to the company policy regarding good faith dispensing during all prescription dispensing activities

●Performed duties as assigned by the Pharmacy Manager, Staff Pharmacist, and Store Manager, including utilizing pharmacy systems to enter patient and drug information

●Resolved customer issues and answered questions to deliver positive customer experience

●Developed strong relationships with valued customers to cultivate customer loyalty

●Reported prescription errors to Pharmacists on duty and adhered to company policies and procedures ● Made telephone calls to Physicians, customers, and patients

●Registered all related sales on the assigned cash register; collected and handled cash ● Assisted customers and patients by offering information on goods and services.

●Cleaned and sterilized work areas, glassware and equipment to protect the pharmacy' s staff and customers

●Priced stock, shelved merchandise and changed signage to reflect current sales information

●Verified written and electronic orders to prevent errors to maintain the optimal security for all pharmacy drugs

●Answered questions from customers such as where to find desired products and explained the pharmacy' s policies

●Supported patients and clinical team members by preparing and delivering medications and supplies

●Carefully counted out and packaged pharmaceutical orders for individuals and bulk needs

●Processed medical insurance claim forms and electronic transmissions to obtain payments for orders

●Engaged customers to understand desires and offer skilled assistance with any need

●Managed daily tasks consistently and sought out opportunities to go beyond requirements and support business targets ● Followed established guidelines and procedures

Shift Lead Jan 2013 Nov 2014

Walgreens

Saint Augustine, FL

●Supervised store employees and monitored machines to determine functionality.

●Implemented solutions or resolved credit issues with customers.

●Managed operations during shift, with total awareness of activities of employees and customers.

●Offering guests and staff a safe environment by strictly enforcing company rules.

●Reviewed customer play and issued complementary services to maintain customer loyalty.

●Guided staff in absence of direct supervisors.

●Maintained awareness of customer activities and good relations with high-value customers.

●Consulted with the Store Manager to provide guidance on best practices and business operations.

●Continuously monitored systems like POS and Back Office to quickly identify and address their issues.

●Reviewed accounts daily to determine the areas in need of improvement and strategies for correcting faults.

●Developed procedures and policies by devising strategies, consistently improving processes and supporting organizational goals.

●Resolved or escalated business problems to keep operations moving smoothly.

●Produced weekly reports outlining the business operations successes and gaps for the senior management team.

●Processed the day-to-day documentation between departments, consistently maintaining effective communication and eliminating bottlenecks.

●Addressed concerns quickly to avoid lasting issues.

●Supported operations with consistent maintenance and updates of corporate files and records. ● Handled deposits, money drops, counted registers and the safe

Cashier/Clerk Mar 2012 Jan 2013

Walgreens

Saint Augustine, FL

●Adhered to all cash handling policies and procedures

●Processed cash register transactions by inputting product costs and giving back change

●Greeted all customers and provided prompt and friendly service

●Operated POS cash register, handling a number of transactions on average daily

●Solved complaints by customers and issued credits for returned merchandise

●Worked in the Photo Department as requested

●Maintained merchandise displays, including end caps, floor displays, and aisles

●Obtained thorough knowledge of products sold to assist customers in locating and purchasing items

●Found ways to improve customer experience by taking accountability and acting as store Brand Ambassador

●Verified prices and calculated totals using scanners and point-of-sale (POS) systems

●Recognized for providing efficient service with high degree of accuracy

●Processed checks, debit and credit cards, EBTs, WIC checks, refunds, product coupons, and gift certificates

●Returned non-purchased products to shelves and performed general merchandising functions

●Assisted customers with locating items, answering questions and providing direction and service ● Bagged and packaged customer orders and purchases

Clerk Cashier Oct 2008 Mar 2011

CVS Pharmacy

Saint Augustine, FL

●Collected payment for customer purchases

●Returned non-purchased products to shelves and performed general merchandising functions

●Greeted all customers and provided prompt and friendly service

●Bagged and packaged customer orders and purchases

●Assisted customers with locating items, answering questions and providing direction and service

●Processed checks, debit and credit cards, EBTs, WIC checks, refunds, product coupons, and gift certificates

●Found ways to improve customer experience by taking accountability and acting as store Brand Ambassador

●Solved complaints by customers and issued credits for returned merchandise

●Verified prices and calculated totals using scanners and point-of-sale (POS) systems

●Obtained thorough knowledge of products sold to assist customers in locating and purchasing items ●

Processed cash register transactions by inputting product costs and giving back change

●Assisted the Photo Department

EDUCATION

CPhT : May 2023June -2025 Certification #30235828

FL RPhT : 70909- 12/31/2024

NC RPhT: 81294- 12/31/2024

High School Diploma: 2008

Pharmacy Technician Immunization Administration Certification: 2022 -2024 Adult, Child and Baby First Aid/CPR/AED: 2022 -2024



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