Pharmacy Technician Prior Authorization

KAREN GALINDEZ CASTRO

**** ********* *****, *******, ** 32738 *************@*****.*** 407-***-****

Summary

Career objectives are to secure a responsible position with a progressive company in which acquired pharmaceutical, administrative, and creative abilities may be effectively utilized. A position which provides continued growth and advancement.

Fluent in Spanish and English

Associate of Science for Pharmacy/ December 2008

Certified and Registered Pharmacy Technician

Skills

Computer Skills: Microsoft Office Suite, Window XP-10, IOS, Internet Explorer, Chrome, Safari, CPR, Guardian Rx, PAS, Cover my Meds, Apex, Baxa

Soft Skills: Team Player, Initiative, Assertive, Adaptability, Detail Oriented, Organized, Ability to focus and Prioritize

Field Skills: Receive written, telephoned, and faxed orders/refill requests. Order, stock, and prepare medications. Inventory maintenance. Knowledge of IV products, compounding procedures, aseptic technique, and USP 797 and cGMP’s. Knowledge of insurance billing, Claims processing, Medicare, prior authorization review and appeals process.

Experience

CarePathRX

Patient Care Advocate/ April 2022 – Present

-Work off low and high margin reports and create daily summary reports.

-Calculate prescription markup, gross margin and profit for a specified period, and insurance reimbursement.

-Complete medication transfers, assisted in process of claim adjudications, verify patient eligibility and prescription benefits, and preparation and submission of claims to insurance companies.

UHG/ OptumRx

Prior Authorization/ September 2020 - March 2022

-Receive incoming calls, faxes, and electronic requests from members, providers, facilities, and other departments while providing excellent customer service.

-Initiate and coordinate prior approval requests for providers and members for medications not covered on a member’s prescription drug plan.

-Schedule peer to peer reviews for physicians to discuss medical necessity.

-Perform detailed medical review of prior approval requests, following established criteria and protocols.

Central Admixture Pharmaceutical Services

IV Technician / August 2011-September 2020

-Assisted in the setup of the compounding room, equipment, and supplies for preparation of compounded sterile solutions using aseptic technique.

-Performed general cleaning and maintenance duties as directed.

-Stocked, prepared pharmacy products and supplies for cleanroom use.

Reference Available Upon Request

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