Receptionist with Experience in Heavy Data Entry and Auditing

RASHELLE HEATH

Phone: 425-***-**** Email: *.*.*****@*******.***

Dependable, organized, and highly adaptable individual with over ten years of experience in fast-paced work environments, proficient in learning new proprietary software systems looking to apply accrued transferable skills and knowledge in customer service, healthcare investigations, document audits, data entry, product ordering, staff training, and compliance measures. Continually applying competencies directed toward client satisfaction, and company success metrics.

SKILLS

Pharmacy Calculations

Pharmacy Operations

Inventory Management

Front Desk and Reception

Appointment Scheduling

Vendor Product Expert

Electronic Record Management

Wholesale Ordering

Document Audits

Retail Sales and Schematics

Customer Service

Microsoft Office Applications

WORK HISTORY

ADMINISTRATIVE

Design PRC review assessment to quantify complex member data, including over 20 significant adverse reporting events, to improve care services involvement for Behavioral Health programs measures.

Participates in TEAMonitor, NCQA, and HEDIS audits, collecting data, communications files, screenshots, highlighting, and annotating detailed information for specific cases under audit review.

Streamlines Medicaid case management and report processes for Washington State Health Care Authority (HCA) Patient Review and Coordination (PRC) program decreasing costs by $155,000 in 3 months.

Investigates technical adjudication issues applying appropriate ICD-10 and Dispense As Written (DAW) codes for timely resolution.

Contacts providers and medical care organizations to clarify prescriptions and initiate prior authorizations, refills, and override requests as necessary.

Contributes to pharmacy team based on trust and accountability to maximize workflow to process over 600 scripts per day.

Train new sales and front desk associates in company protocols and annually review operating procedures.

Receive and verify daily shipments from distribution centers, reported discrepancies, and logged over 200 replenishment items into the inventory system.

Record and transfer outdated, damaged, overstock, and return to vendor medications in computer inventory systems.

MARKETING/SALES

Created SOP for interdepartmental review, and decreased submission of 230 Medicare documents consistent with outfacing company branding to the Pharmacy Benefit Manager (PBM) from 40 to 14 days.

Consult over 20 current members monthly, quickly building trust to further fitness goals, and gaining 5 referrals on average from members to grow the business.

Calculated product pricing for clients and enters product orders and submits to appropriate vendors, follows up to ensure product delivery time using tracking system and troubleshoot delivery discrepancies.

Recognized by management for my product knowledge of over 20 vendors vendor specific unique branding driving up client base loyalty by 20% compared to the previous year.

Created floor schematics with supervisor to highlight new vendors where highest exposure to customer traffic would increase sales to and exceed department sales projections.

CUSTOMER SERVICE

Greets patients and members of hospital staff with enthusiasm at drop-off and pick-up windows, adhering to HIPAA confidentiality, verified identification, updated medical records as needed, collects payment and defers new prescriptions to pharmacist consult.

Refers patients to appropriate services within UW Medical Center for enrollment in medical insurance, care coordination, financial aid assistance, and other benefits available as appropriate.

Collects co-payments at POS and refers the patient to the pharmacist for care consultation on new prescriptions.

Assists Customer Service with in-network pharmacies and provider inquiries for prescription claims, prior authorizations, formulary tiering updates, and lost or stolen medication overrides.

WORK EXPERIENCE

The Petal and the Stem, Event Staff/Customer Service 05/2022 - Present

Emerald City Athletics, Assistant Manager/Member Sales 12/2019 - 07/2020

Community Health Plan of Washington, Pharmacy Operations Technician 04/2017 - 12/2019

University of Washington Medical Center, Pharmacy Technician 07/2016 - 12/2016

EDUCATION

Bellevue College 09/2020 07/2022

AAS Diagnostic Ultrasound Technology Bellevue, WA

3.65 GPA

Relevant Coursework: Technical Writing, Statistics, Intercultural Communications and Anatomy.

Everest College 01/2013 - 11/2013

Pharmacy Technician Everett, WA

CERTIFICATIONS

Washington State Pharmacy Technician License 04/2014 - 9/ 2023

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