Certified Pharmacy Technician - 10+ Years Experience in Pharmacy
Resume:
Natalia Cooley
(Local to Fort Worth, TX ***** and Immediately Available)
Supplier Summary:
●Natalia is Certified Pharmacy Technician with 10+ years of experience filling prescriptions, processing insurance claims and maintaining customer relations in high-traffic pharmacies with certification number 208833 valid till 01/31/2027
●Communicate with patients, healthcare providers, and insurance companies to obtain necessary information, clarify details, and address any questions or concerns related to prior authorizations, insurance coverage, or claims processing.
●Ensuring all necessary information is captured and entered correctly, including patient demographics, insurance details, healthcare provider information, and specifics about the requested medical services, procedures, or medications.
●Maintain detailed records of labeling activities, including batch records, labeling logs, and any deviations encountered during the labeling process.
Education:
Everest College, Arlington, TX 2014
Certifications:
Pharmacy Technician Certification Board (PTCB) 2014
Texas State Board of Pharmacy
Skills:
●Pharmaceutical Calculations
●Customer Service Representative
●Typing
●Data Entry
●FDA Compliance Inventory Management
●Quality focus
●Dependability
●Attention to Detail
●HIPPA and OSHA Trained
Written and Interpersonal Communication Skills
Experience:
Alto Pharmacy October 2023-May 2024
Contact care specialist II
●Responsible for reviewing requests submitted by healthcare providers, pharmacies, or other entities for medical services, procedures, or medications that require prior authorization from insurance companies.
●Understanding of insurance policies, coverage guidelines, and medical necessity criteria set by the insurance company or payer to determine whether a prior authorization request meets the necessary criteria for approval.
Enter relevant information into the healthcare organization's electronic systems accurately and efficiently. This includes documenting the outcome of prior authorization reviews, noting approvals or denials, and maintaining detailed records of prior authorization requests and decisions.
UnitedHealth Group July 2022-April 2023
Prior Auth Technician
●Responsible for reviewing requests submitted by healthcare providers, pharmacies, or other entities for medical services, procedures, or medications that require prior authorization from insurance companies.
●Understanding of insurance policies, coverage guidelines, and medical necessity criteria set by the insurance company or payer to determine whether a prior authorization request meets the necessary criteria for approval.
●Enter relevant information into the healthcare organization's electronic systems accurately and efficiently. This includes documenting the outcome of prior authorization reviews, noting approvals or denials, and maintaining detailed records of prior authorization requests and decisions.
Spectrum Health – Remote Jun 2021 – Nov 2021
Prior Auth entry / Insurance verification/adjudication
●Communicate with patients, healthcare providers, and insurance companies to obtain necessary information, clarify details, and address any questions or concerns related to prior authorizations, insurance coverage, or claims processing.
●Effective communication skills are essential in providing excellent customer service and resolving issues promptly and professionally.
●Maintain detailed records of prior authorization requests, insurance verification activities, claim submissions, and payment transactions.
●Accurate documentation tracking the status of prior authorization requests and insurance claims and for ensuring compliance with regulatory requirements.
IQVIA-Remote Dec 2020 – May 2021
Prior Auth entry / CSR
●Providing excellent customer service to patients, healthcare providers, and other stakeholders via phone, email, or other communication channels.
●Responding promptly to inquiries, concerns, and requests for information related to prior authorizations, insurance coverage, and claims processing.
●Clarifying procedures, addressing questions, and resolving issues to ensure a positive customer experience.
●Ensuring all necessary information is captured and entered correctly, including patient demographics, insurance details, healthcare provider information, and specifics about the requested medical services, procedures, or medications.
●Following established protocols and guidelines for entering prior authorization requests to facilitate efficient processing and decision-making.
Carie Boyd-Irving, TX Feb 2020 – May 2020
Pellet Tech/Labeling sterile vials
●Maintain detailed records of labeling activities, including batch records, labeling logs, and any deviations encountered during the labeling process.
●Accurate documentation is essential for traceability, regulatory compliance, and quality assurance purposes.
●Operate labeling equipment and machinery used in the labeling process, such as label applicators, printers, and inspection systems.
●Ensure that equipment is properly calibrated, maintained, and sanitized to prevent contamination and ensure product integrity.
McKesson- Irving, TX Jul 2018 – Jan 2019
Pharmacy Technician
●Input patient demographics into the CPR plus system
●Input prescription data into the computer and process the patient's insurance
●Gather, organize, document, and report clinical data for review and action by the patient care team
Prime Therapeutics- Irving, TX March 2017- July 2018
Pharmacy Technician
●Answer in-bound calls concerning patient prescriptions
●Data entry of patient and prescription orders Prepare medications by reviewing and interpreting
●physicians orders
AmerisourceBergen- Frisco, TX Jul 2016 – Mar 2017
Pharmacy Technician
●Communicate with insurance companies regarding patients copays
●Interact with physician offices regarding authorization approvals
●Researched, updated clarifications and denials on patient profiles
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