Pharmacy Technician Prior Authorizations
Resume:
Dshawna Gay
Tampa, FL *****
**********@*****.***
Professional Summary
To acquire a challenging position in an environment where I can best utilize my best skills, education, and be challenged.
#readytowork
Authorized to work in the US for any employer.
Willing to relocate: Anywhere
Work Experience
Appeals Coordinator
Aetna-Tampa, FL
June 2024 to Present
· Processing claims
· Paying close attention to detail
· Ability to interpret a variety of work instructions provided through multiple mediums.
· handling constant changes
· Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues and may require coordination of responses from multiple business units.
· Ensure timely, customer focused response to complaints/appeals.
· Identify trends and emerging issues and report and recommend solutions. Pharmacy Technician (Helpline Rep, LA, POC)
CVS Health
June 2021 to Present
· Prior authorizations
· reviewing criteria
· making and receiving calls to and from the doctor’s office
· handling inbound calls from the member
· Following CMS guidelines
· Working with Pharmacists
· handling constant changes
· Paying close attention to detail
· Researching and correcting any issues found in the overall process. Raising issues to Organization Determination Clinical Pharmacists and Management team as needed.
· Performing basic mathematical calculations. Ensuring all cases are properly closed
· Working incoming cases via phone or fax to process coverage requests from members or prescribers.
· Ability to interpret a variety of work instructions provided through multiple mediums.
· Ability to anticipate needs and resolve issues with urgency and to meet quality and production standards.
In my previous role as a helpline rep, LA, POC, I help answer questions and provide guidance to my direct team, facilitate side by sides through case shadowing, lead refresher trainings, etc. I completed the LA training that allows me to assist in new hire training and PRC/ nesting. Pharmacy Technician (contingent to FTE Employment) Managed Staffing Inc-Tampa, FL
October 2020 to June 2021
· Prior authorizations
· reviewing criteria
· making and receiving calls to and from the doctor’s office
· handling inbound calls from the member
· Following CMS guidelines
· Working with Pharmacists
· handling constant changes
· Paying close attention to detail
· Researching and correcting any issues found in the overall process. Raising issues to Organization Determination Clinical Pharmacists and Management team as needed.
· Performing basic mathematical calculations. Ensuring all cases are properly closed
· Working incoming cases via phone or fax to process coverage requests from members or prescribers.
· Ability to interpret a variety of work instructions provided through multiple mediums.
· Ability to anticipate needs and resolve issues with urgency and to meet quality and production standards.
Pharmacy Technician
Computech Corporation-Tampa, FL
October 2019 to April 2020
· Prior authorizations
· reviewing criteria
· making and receiving calls to and from the doctor’s office
· handling inbound calls from the member
· Following CMS guidelines
· Working with Pharmacists
· handling constant changes
· Paying close attention to detail
· Performing basic mathematical calculations. Ensuring all cases are properly closed.
· Working incoming cases via phone or fax to process coverage requests from members or prescribers.
· Ability to interpret a variety of work instructions provided through multiple mediums.
· Ability to anticipate needs and resolve issues with urgency and to meet quality and production standards.
Pharmacy Technician
Walgreens
August 2019 to January 2020
· Take and translate e-prescriptions over the phone and in person
· work with health professionals and customers
· compound medications
· count pills
· measure medications
· label and give information for medicine
· Assist with cash handling
Pharmacy Technician Intern
Walgreens-Tampa, FL
June 2019 to August 2019
CNA - Certified Nursing Assistant
Fletcher Allen Healthcare-Tampa, FL
July 2018 to November 2018
· Assisting with ADLS
· laundry
· VS
· ROM
· reposition
· assisting with meals
· reporting changes to nurses
· working alongside an LPN or RN
· bathing
· feeding
· changing
CNA - Certified Nursing Assistant
PruittHealth-Decatur, GA
April 2017 to April 2018
· Assisting with ADLS
· laundry
· VS
· ROM
· reposition
· assisting with meals
· reporting changes to nurses
· working alongside an LPN or RN
· bathing
· feeding
· changing
Education
Skills
• Inventory
• Outlook
• Information Technology
• Laundry
• EMR Systems
• Pharmacy Technician Experience
• Medical Records
• Customer service
• Data entry
• Patient Care
• 55 wpm
• Vital Signs
• Billing
• Medical Office Experience
• Typing
• Medical Terminology
• Cash Handling
• Microsoft office
• ICD-10
• HIPAA
• Word
• Insurance Verification
• Excel (6 years)
• Pharmacy
• Medical Billing
• Organizational skills
Certifications and Licenses
CPR Certification
BLS Certification
Pharmacy Technician Certification
CNA
State Tested Nursing Assistant
AED Certification
Pharmacy Technician License
Registered Pharmacy Technician
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