Benefit Manager Pharmacy

Mohammed Altaf Siddiqui

Voice: 224-***-****

********@*****.***

**** * ****** ** *** Plaines, IL 60016

Objective: To obtain a position which will allow my skills to be utilized in the company’s best interest. I offer my strong work ethic, team effort, experience, bilingual abilities and professional demeanor.

SUMMARY:

Independent thinker successfully overseeing a busy performing multiple tasks, including motivated professional offering exceptional quality in any work I put in. My knowledge adds great value to any organization in need of great collaboration, interpersonal, and multitasking abilities.

I meet tight deadlines every time. I am hardworking and reliable with strong ability in and around big crowds. I am highly organized, proactive, and punctual with team-oriented mentality.

Strong knowledge of many areas of expertise. Communicative and team-oriented with proficiency. Proven history of fostering to meet team, individual and management objectives.

Hardworking and reliable with strong ability offering hard working, great attitude and yet very strong work ethic. Highly organized, proactive, and punctual with team-oriented mentality.

Strong leader and problem solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgement to positively impact company success.

CVS Specialty Pharmacy (CVS Healthcare)

800 Biermann Ct

Mt. Prospect, IL 60016

Dept: (Benefit Verification)

Working as Rep II since May 30, 2017 to March 12, 2024

Responsible for accurate and timely verification of a new and existing patients

Disposition cases appropriately

Performing ECS rejections to call pharmacy benefit manager to get processing information.

Conduct complicated benefit investigation for complex payer

Contact insurance carriers to resolve electronics claim submissions.

Create and register new files with EPIC software, use covermymats.com and navinate.com for prior authentications, and update pharmacy benefit manager

Verify patient coverage with insurance companies

Perform MAJ to verify a method of payment for patients’ financial responsibility to prevent company costs

To obtain benefits using websites such as availity.com, navinate.com, emdiomoffice.com, cigna.com, umr.com, uhc.com, optemrx.com

Conduct proactive and requested prior authentications to address issue regarding bad debt or entitlement

Working with pharma contracts and HUBs for patient service reporting and follow up on investigation.

Follow all procedure for payers and manufacturers programs to ensure all contractual obligations are met.

Enter all verified information to the SPRX’s application

Working all escalated referrals in priority bases.

Contact MD to verify the doses of the patients based on cases.

Qualified Work Experience

Q.C Inspector 2008-2015

Lake Region Medical Wheeling, IL

Visual and Dimensional inspection of medical tooling parts

Also document control of outside vendors, in-process sterilization, and incoming materials by using Visual and Quality Database Software in addition maintained SPC data and Infinity QS data to record the consistency of acceptable dimensions.

Supervisor Assistant 2007-2008

Accellent Endoscopy Wheeling, IL

Training employees to manufacture production process, 5S process, collect Kan ban data

Lead Setup Operator 2004-2007

Accellent Endoscopy Wheeling, IL

Punch Assorted, Auto punch press line, Lathe machines, Wire EDM machines

Machine operator 2002-2004

Accellent Endoscopy Wheeling, IL

Punch Assorted, Auto punch press line, Lathe machines, Wire EDM machines

Education

High School, Hyderabad, India 1995-1999

ASQ blue print reading certified 2005

GD&T ASQ certified 2005

CDL (General Courses) 2009

Relevant Skills

Worked with calipers, micrometers: digital, blade, thread, point, pin, and laser. Also worked with

height, drop, pin, ball, angle and radius gage. In addition extensively worked with Optical

Gaging Products Smartscope.

Experience using:

. International Standard ISO 9000

. International Standard ISO 9001

. International Standard ISO 13485

. FDA Quality System Regulation (QRS’s) 21CFR820

Other Skills

CDL Class B for Passenger transportations and operate school bus for part time

Software Experience

Windows 95, 98, XP pro/Media, Excel, Word, Internet Explorer,

Visual, Quality Database, InfinityQS, SPC, Oracle and Kaba clock system

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