Customer Service Representatives
Resume:
SUMMARY
Resourceful and highly organized professional with extensive experience in administrative support, prior authorization, and customer service. Proven ability to manage patient data, process claims, and maintain meticulous records, ensuring compliance and efficiency. Adept at coordinating schedules, handling communications, and managing documentation within fast-paced environments. Eager to leverage strong organizational, multitasking, and communication skills to support Steel Sky Studio LLC in a remote Virtual Assistant role.
WORK EXPERIENCE
Prior Authorization Specialist, United Healthcare, Remote 09/2024 – 12/2024
Generated and dispatched denial letters, clearly stating reasons for denial and outlining potential appeal measures.
Contacted insurance carriers to secure prior authorization for necessary testing and medical procedures.
Accurately input all patient data related to claims and prior authorizations into the system. Verified provider eligibility and ensured compliance with service authorization requirements. Acquired and logged precise patient insurance and demographic information for utilization by insurance providers and medical staff.
Analyzed medical records and supporting documents to determine the approval status of authorization requests.
Responded to inquiries from healthcare providers concerning pending prior authorization requests. Cultivated and maintained productive professional relationships with healthcare providers. Assessed clinical criteria to approve or deny services that required pre-authorization. Assisted clients with the accurate completion of applications and required paperwork. Adhered to established guidelines when reviewing applicant data to ascertain eligibility for economic assistance.
Pharmacy Technician, Rite Aid, Lafayette
01/2011 – 12/2018
Delivered exceptional customer service, addressing patient needs and inquiries. Managed and processed prior authorization calls to facilitate prescription fulfillment. Accurately counted pills and meticulously filled prescriptions according to physician orders. Maintained accurate inventory by stocking, labeling, and organizing medications. Joselyn Anderson
Virtual Assistant
CONTACT
Lafayette, 70506
*****************@*****.***
https://bold.pro/my/joselyn-anderson-241*********/782r Procured daily medication orders to replenish stock and ensure adequate inventory levels. Verified accuracy of item and quantity when labeling and counting prescriptions. Collected co-payments and full payments from customers for prescriptions and services. Gathered essential patient information regarding prescriptions and medical conditions to facilitate pharmacist consultations.
Entered and processed patient prescriptions accurately within the internal pharmacy system. Ensured compliance with drug storage protocols, including maintaining registries and records for controlled substances.
Managed incoming phone calls, addressing questions from customers and healthcare providers efficiently.
Greeted customers and provided information regarding prescriptions and over-the-counter products. Collaborated with pharmacists to resolve prescription issues and respond to customer queries, enhancing pharmacy workflow.
Provided consultations and addressed inquiries from patients, healthcare professionals, and physicians concerning drug usage, potential side effects, and proper application. Coordinated verification and filling of over a specified number of daily prescriptions within a high- volume pharmacy setting.
Prepared prescription packaging and labels, verifying the accuracy of dosage, potential side effects, drug interactions, and refill instructions.
Clinical Associate Administrator, Optum, Remote, USA 03/2025 – PRESENT
Assist members with scheduling house call visits through their insurance company EDUCATION
Remington College-Lafayette Campus, Certified Pharmacy Technician, Pharmacology, Lafayette North Side High School, High School Diploma, Lafayette SKILLS
Pharmacy technician Prior Authorization
HIPAA Data Entry
Medical Billing Clinical Pharmacy Experience
Hospital Experience Insurance Verification
Research Order Entry
Typing Transcription
Microsoft Office (Word, Outlook and Excel) Phone Etiquette Excellent Communication Customer Service skills
Organization File Management
Microsoft Office Suite Google Workspace
Multitasking Time Management
Self-Management Written Communication
Scheduling Software Data Entry
File Management Cloud Storage
Expense Tracking Software CRM Software
Project Management Basics
CERTIFICATES
PTCB Certification
Pharmacy Technician Certification
Pharmacy Technician License
11/2010
Certified Pharmacy Technician
11/2011
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