Pharmacy Technician Certified
Resume:
High School Diploma:
West Allis Central
Certified Pharmacy Technician
(CPhT):
Milwaukee Area Technical
College
Medical Coding Specialist:
Waukesha County Technical
College
*******@*****.***
West Allis, WI 53227
WWW: Bold Profile
Core Competencies
Provider enrollment and record
setup
•
• ICD-10 and CPT coding
• Analytical thinking
• Billing and coding
• HIPAA compliance
• Insurance billing
• Claim research and resolution
Medicare, Medicaid, and
third-party billing
•
• Data entry
• Validation and accuracy review
• Revenue cycle management
Denials management and
compliance
•
• Workflow improvements
• Cross-functional collaboration
• Microsoft Office proficiency
Healthcare claims systems
knowledge
•
Education &
Certifications
Certifications
Certified Medical Coder (CPC-A ) -
AAPC
•
• Certified Pharmacy Technologist
Detail-oriented certified CPC-A with extensive experience in ICD-10 and CPT coding. Proven track record in claim rejection research and resolution, ensuring compliance with HIPAA regulations.
Advocate Aurora Central Fill Automation - Certified Pharmacy Technician 08/2024 - Current
ARAS Promotions - Brand Ambassador
05/2016 - Current
Greenfield Rehabilitation - Billing Specialist
06/2023 - 03/2024
Aurora At Home Pharmacy - Pharmacy Service Representative 10/2020 - 03/2021
Aurora Cancer Care - Patient Charge Capture Representative 06/2013 - 07/2020
Marlena Tzakis
Professional Summary
Professional Experience
Accurately processed prescription orders through automated and manual systems, ensuring proper setup and documentation.
•
Monitored and corrected data discrepancies related to medication counts, packaging, and inventory.
•
Partnered with pharmacists to maintain compliance and accuracy in data-driven workflows.
•
Collaborate with diverse teams to deliver accurate brand information, requiring flexibility, problem-solving, and multitasking skills.
•
Entered, reviewed, and submitted billing data to ensure the accurate setup of payer/provider records for reimbursement.
•
Researched and resolved rejected claims by validating coding, authorizations, and benefit details.
•
Ensured compliance with federal and commercial payer requirements, reducing rejections and delays in payment.
•
• Conducted audits of medical records to identify errors in coding practices.
• Maintained knowledge of ICD-10, CPT, HCPCS, and other relevant coding systems.
• Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing. Verified patient insurance and provider details to ensure accuracy before claims submission.
•
Collaborated with pharmacists to resolve discrepancies in provider/payer requirements, preventing errors and rejections.
•
Websites, Portfolios,
Profiles
Aurora West Allis Memorial Hospital - Certified Pharmacy Technician 06/1999 - 06/2013
Walgreens - Pharmacy Technician
06/1997 - 06/1999
References available upon request.
Accurately entered and audited chemotherapy drug charges, ensuring provider billing alignment with treatment documentation.
•
Partnered with nurses and billing teams to identify inaccurate data and correct it for compliance, and proper reimbursement.
•
Supported 20+ oncology clinics in resolving billing discrepancies and maintaining accurate provider charge records.
•
Verified accuracy of diagnostic codes assigned by providers through ICD-10-CM coding conventions and CPT coding guidelines.
•
• Assisted with coding diagnoses and procedures for billing purposes. Managed accurate preparation, documentation, and delivery of IV/oral medications.
•
Responded to provider and nursing data inquiries, ensuring accuracy of medication orders and billing records.
•
Entered prescription and payer data into claim processing systems, resolving rejected claims through accurate data correction.
•
References
Contact this candidate