Pharmacy Technician Customer Service
Resume:
Melanie D. Rasmussen
Melanie Rasmussen
Gridley, Ca 95948
*********@*****.***
I am a dedicated, hardworking person. I am self-motivated. I can work alone or with a group. I am a quick thinker and a problem solver. I like to have processes run smoothly and can adapt easily to change. I enjoy taking on tasks, no matter how easy or hard they may be. I have knowledge that cannot be obtained in a classroom. I believe in having a strong work ethic, passion, dedication, as well as pride and integrity in one's work. It is important to have a systemic workflow with accountability. It is important to be proactive instead of reactive. Always look at the road ahead and plan your approach that way.
Authorized to work in the US for any employer.
Work Experience
Provider Partnership Associate
Centene Corporation- Remote (Natomas Ca)
August 2022-October 6, 2023
Responsibilities:
*Liaison between provider and insurance company
*Maintain, improve, or achieve performance and quality metrics
*Assist with quality, identify barriers, and best practices among all Lines of Business.
Pharmacy Technician Crystal Pharmacy -Oroville, CA
February 2017November 2021
Responsibilities:
*Answering phones.
*Medi-Cal Subject Matter Expert
*Medicare subject Matter Expert
* Medicare/Medicaid hand bills, as well as Workman’s comp, and specialty programs (i.e., California Children Services, Victim Witness, Public Guardian, P.R.C.S. program)
*Far Northern
*Customer Service
*Processing and filling of prescriptions timely, safely, and accurately, via phone, electronic, handwritten, or fax. Ensuring that all necessary information is within the RX as well as validating it. (Diagnosis, qty, code 1 restrictions met, etc.)
*All stages of prior authorizations-Obtaining/follow up/ processing from a multitude of different insurance companies
*Audits (desk audits/onsite)
*Assist in Admin duties when necessary
*New Hire Training/ Onboarding
*Ordering and returning RX and OTC stock to maintain overhead. Using data analysis to have sufficient supplies of all necessary products.
*Pulling outdated product from shelves and completion of return process for credit due or destruction.
*Returns of stock medications as well as RTS’s of filled medications in a timely manner according to payor guidelines.
* Pt advocate between insurance companies, as well as providers
*Product training and troubleshooting with patients for diabetic supplies, urological, ostomy, breathing supplies (i.e. nebulizer machines)
*Computer and network troubleshooting.
*Maintenance on devices as necessary (computers, printers, phones,
copy machines, fax machines, signature pads, cash registers.)
*Ordering and stocking of office supplies
*Ordering pharmacy stock, i.e. blister packs, vials, lids,
*Contacting software vendor(s) as needed for system and or robotics machine
*Medicare Coordinator including timeliness, accuracy, and stock of Medicare DME products,
*Filling out paperwork products, filling out paperwork,
accreditation
*Behavioral Health liaison
Med boxes, prior authorizations,
special circumstances
*SNF/Board and Care liaison which included but not limited to, obtaining new or refill medications, bubble packing, staying up to date on rules/regulations for such facilities, Long Term Care contract structures and implementations
*Billing, processing accurately, maintaining accurate up to date records in all aspects of pharmacy in accordance too state and federal guidelines, laws, and Medicare standards.
*Insurance Recon, E.O.P.’s, Corrective actions with any discrepancies
*Patient adherence, MTM’s, CMR, setting up consultation appointments with pharmacist, requesting refills.
*Delivery Coordination
Pharmacy Technician
Rite-Aid Pharmacy Oroville, Ca. 95966
November 2016-February 2017
Responsibilities
*Answering phones.
*Customer service
*Medi-Cal Subject Matter Expert
*Medicare subject Matter Expert
*Processing and filling prescriptions timely safely and accurately
*Prior Authorizations-Obtaining/follow up/processing of from a multitude of different insurance companies
*Maintaining sufficient stock and returns of medication.
*Pt advocate with insurance companies and doctors’ offices
*Answering phones.
*Applying for and or requesting prior authorization for medications for patients.
Pharmacy Technician
Olive Pharmacy - Oroville, CA
May 2009- November 2016
Responsibilities:
*Answering phones.
*Customer service
*Medi-Cal Subject Matter Expert
*Medicare subject Matter Expert
*Processing and filling prescriptions timely safely and accurately
*Prior Authorizations-Obtaining/follow up/processing of from a multitude of different insurance companies
*Maintaining sufficient stock and returns of medication.
*Pt advocate with insurance companies and doctors’ offices
*Answering phones.
*Applying for and or requesting prior authorization for medications for patients.
*Computer maintenance
*Contacting software vendor to fix issues or fix myself.
Pharmacy Technician
Crystal Pharmacy -Oroville, CA
January 1993-November 2008
Responsibilities:
*Answering phones.
*Medicare/Medicaid hand bills, as well as Workman’s comp, and specialty programs (i.e., California Children Services, Victim Witness, Public Guardian, P.R.C.S. program) *Medi-Cal Subject Matter Expert
*Medicare subject Matter Expert
*Far Northern
*Customer Service
*Processing and filling of prescriptions timely, safely, and accurately, via phone, electronic, handwritten, or fax. Ensuring that all necessary information is within the RX as well as validating it. (Diagnosis, qty, code 1 restrictions met, etc.)
*All stages of prior authorizations-Obtaining/follow up/ processing from a multitude of different insurance companies
*Audits (desk audits/onsite)
*Assist in Admin duties when necessary
*New Hire Training/ Onboarding
*Ordering and returning RX and OTC stock to maintain overhead. Using data analysis to have sufficient supplies of all necessary products.
*Pulling outdated product from shelves and completion of return process for credit due or destruction.
*Returns of stock medications as well as RTS’s of filled medications in a timely manner according to payor guidelines.
* Pt advocate between insurance companies, as well as providers
*Product training and troubleshooting with patients for diabetic supplies, urological, ostomy, breathing supplies (i.e. nebulizer machines)
*Computer and network troubleshooting.
*Maintenance on devices as necessary (computers, printers, phones, copy machines, fax machines, signature pads, cash registers.)
*Ordering and stocking of office supplies
*Ordering pharmacy stock, i.e. blister packs vials, lids
*Contacting software vendor(s) as needed for system and or robotics machine
*Medicare Coordinator including
timeliness, accuracy, and stock of Medicare DME products, filling out paperwork, accreditation.
*Behavioral Health liaison
Med boxes, prior authorizations, special circumstances
*SNF/Board and Care liaison which included but not limited to, obtaining new or refill medications, bubble packing, staying up to date on rules/regulations for such facilities, Long Term Care contract regulations.
*Billing, processing accurately, maintaining accurate up to date records in all aspects of pharmacy in accordance too state and federal guidelines, laws, and Medicare standards.
*Insurance Recon, E.O.P.’s, Corrective actions with any discrepancies
*Patient adherence, MTM’s, CMR, setting up consultation appointments with pharmacist, requesting refills.
*Delivery Coordination
Education
General Education
Las Plumas High School - Oroville, CA 95966
August 1991 to June 1995
High school diploma
License(s)
Registered Pharmacy Technician (California)
California Driver’s License
Skills
•Special Education
•Time Management
•Medical Terminology
•Typing
•Cash Handling
•Medical Billing
•Strong knowledge of Medicare and Medicaid (Medi-Cal)
•Knowledge of Managed Care plans
•Insurance Verification
•HIPAA
•FWA
•Training/Onboarding
•Medical Office Experience
•Customer Service
•Follow through.
•Pharmacy
•Inventory
•Billing
•CPT Codes
•NDC
•ICD-9 & ICD-10 Coding
•ICD-9/ICD-10 Crossover-Crosswalk
•Data Collection
•Microsoft Office
•Data Entry
•Transcription
•Phone Etiquette
•Computer Literacy
•Teaching
•Diabetic Testing/Coding and billing knowledge
•Ostomy Supply and billing knowledge
•Urological Supply and billing knowledge
•Incontinence Supply and billing knowledge
•Claims Submission
•Claims Auditing (In person/desk audit)
•Accounts Payable
•Accounts Receivable
•Charge Accounts
•Collections
Contact this candidate