SUMMARY
Remarkable career history in the pharmacy field with areas of expertise in retail, pharmacy benefits, institutional settings and account management. Strengths include detail oriented, dependability, and in depth analytical thinking which demonstrates talent in identifying and handling complex problems and situations.
SKILLS
• Windows (Word, Power Point & Excel)
• People Soft
• Knowledge of RxClaim
• 5 years’ experience in Pharmacy benefits and account management
PROFESSIONAL EXPERIENCE
BLUE CROSS BLUE SHIELD OF TEXAS, RICHARDSON, TX 2007-PRESENT
Pharmacy Benefits Coordinator
• Work with clients and account management as a subject matter expert on interpretation and implementation of pharmacy benefits on new and existing accounts.
• Work with PBM vendor to ensure all pharmacy claims are paid accurately and groups are receiving correct benefits.
• Validate coding accuracy utilizing various tools.
• Manage sales initiatives by participating on calls with clients & facilitate the explanation of pharmacy plans and operations for mid-market and national accounts.
• Provide support to other areas in response to group and member pharmacy benefits inquiries.
• Analyze data, gathered and develop solutions or alternative methods of proceeding.
• Request, review and interpret utilization and impact reports to client.
CAREMARK, IRVING, TX 2006-2007
Pharmacy Technician (Prior Authorization)
• Answer calls related to Prior Authorization using appropriate criteria forms.
• Work closely with RPh on prior authorization of specialty medications.
• Process prior authorization request and enter authorization into Rxclaim system.
• Resolve customer pharmacy issues; ensuring accurate information is provided.
• Consistently meet established productivity and quality standard while maintaining a good attendance record.
• Trouble shoots claims that are not processing after the PA was entered into the system.
CVS PHARMACY, DUNCANVILLE, TX 2005-2006
Pharmacy Technician
• Ordered and shelved RX/OTC drugs.
• Filled bottles with prescribed medications and type and affix labels.
• Mixed pharmaceutical preparations according to written prescriptions.
• Received written prescription or refill requests and verify that information is complete and accurate.
• Answered telephones, responding to questions or requests.
METRO STATE PRISON, MORROW, GA, 2004-2005
Pharmacy Technician
• Ordered and shelved Rx/OTC drugs.
• Handled all Nurses/MD inquiry regarding inmate’s medication orders.
• Filled bottles with prescribed medications and type and affix labels.
• Mixed pharmaceutical pre...
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