Customer Service Technician

Heather Marie Vega

**** ****** **** **

Montgomery, Alabama 36109

Cell: 334-***-****

Email: *******.*****.****@*****.***

Candidate Profile

Bachelor of Science in Biology with concentration in Public Health and Microbiology. Ten years of combined healthcare experience ranging from retail pharmacy to pharmacy administrative services for the Alabama Medicaid Agency. Serving as Chair for the Alabama Pharmacy Association Pharmacy Technician Academy. Excellent problem solving and communication skills, works well with minimal supervision, and manages time efficiently. Proficient in Microsoft Word, Excel, and Outlook.

Education

Auburn University Montgomery (AUM), Montgomery, Alabama 2007- 2011

Bachelor of Science in Biology

• Concentration in Public Health and Microbiology

Experience

Health Information Designs, Inc-Auburn, Alabama 2007- present

Pharmacy Technician

• Maintain the Alabama Medicaid Agency drug file

• Assists recipients and providers with reimbursement and claim adjudication issues

• Manage professional contract(s) with the Alabama Medicaid Agency

• Performs system testing and analysis of pharmacy claims data and statistics

• Experience in calculating percent increases and decreases in pharmaceutical price changes

• Ensures that pharmacy providers are aware of rules and regulations set forth by the Alabama Medicaid Agency and State Board of Pharmacy related to claim processing and drug coverage

• Ensures compliance of Medicare and Medicaid rules related to federally rebated drug

coverage, Medicare coverage, and DESI drug coverage

• Assist providers with J-code billing

• Perform quarterly audit and cost savings analysis

• Assist with provider audits as needed

• Review HCPCS (J-code) quarterly updates, assign quantity restrictions, age restrictions, and diagnosis restrictions (ICD9) and verify max fee against Medicare’s ASP file.

• Complies with the rules of the Alabama Medicaid administrative code and billing manuals.

CVS Pharmacy-Montgomery, Alabama 2001- present Pharmacy Technician

• Provide customer service

• Perform data entry, production, and prescription pick-up

• Assist patients with insurance problems

• Assist pharmacist and ensure compliance of State Board of Pharmacy rules and regulations

• Maintain supplies and inventory

• Research and resolve third party rejections, ensure proper billing and reimbursement of pharmacy claims, and ensure that the patient is aware of third party issues

• Coordinate pharmacy technician scheduling

• Supervised technician’s, conducted training and quality assurance with technician’s

References available upon request

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