With a proven track record at Vanderbilt Medical Center, I excel in claims processing and delivering exceptional customer service. My expertise in insurance verification and problem-solving has significantly enhanced team productivity and patient satisfaction. Known for reliability and effective communication, I consistently achieve goals with precision and a keen attention to detail.
I have implemented changes early on to Map in order to make work more efficient.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Pharmacy Reimbursement Specialist
Vanderbilt Medical Center
02.2016 - Current
Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
Managed multiple priorities effectively under high-pressure deadlines without compromising accuracy or quality of work output.
Created training materials and led sessions for new hires, ensuring they were equipped with the necessary skills to excel as Reimbursement Specialists.
Responded to customer concerns and questions on daily basis.
Knowledgeable with the Map program and try to make changes to be more efficient
Learned how to work with PAP programs in scheduling delivery of medications by looking up infusion dates and making notes in Med Data
Senior Certified Pharmacy Technician
Vanderbilt Medical Center
01.2010 - 02.2016
Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.
Answered incoming phone calls and addressed questions from customers and healthcare providers.
Collected co-payments or full payments from customers.
Conducted regular inventory audits to identify discrepancies and reduce instances of stockouts or expired medications on pharmacy shelves.
Maintained a clean, organized work environment to uphold quality standards and minimize risk of contamination or error during medication preparation.
Stocked, labeled, and inventoried medication to keep accurate records.
Improved patient satisfaction scores by delivering exceptional customer service in a fast-paced, high-volume pharmacy setting.
Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
Ensured compliance with federal and state regulations by maintaining meticulous documentation of controlled substances and adhering to strict safety protocols.
Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
Reviewed and verified customer information and insurance provider information.
Optimized workflow processes to maintain accurate prescription records and ensure timely order fulfillment for patients.
Collaborated with pharmacists to review and verify prescriptions, ensuring accurate dosages, drug interactions, and possible allergies were considered before dispensing medications.
Answered patients' questions and troubleshot prescription issues.
Resolved non-routine issues like third-party billing, computer system, and customer service issues.
Counted, measured, and compounded medications following standard procedures.
Advocated for patients' compliance with medication guidelines.
Maintained relationships with physicians.
Prepared bottle labels.
Streamlined insurance billing procedures to expedite claims processing while reducing errors related to inaccurate coding or incomplete information submission.
Maintained and updated patient records, prescription information and patient data in accordance with HIPAA regulations.
Set up and modified patient profiles in [System] to include current information such as medications and insurance details.
Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
Resolved third-party billing, computer system and customer service issues.
Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
Coordinated verification and filling of more than [Number] daily prescriptions in high-volume [Type] pharmacy environment.
Managed opening and closing duties for pharmacy.
Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
Coordinated with physicians and insurance agency representatives for speedy resolution of prescription discrepancies.
Set up and modified patient profiles to include current medications and insurance details.
Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
Precisely measured and combined ingredients to deliver scrupulous formulation on customer compound prescription orders.
Senior Certified Pharmacy Technician
Vanderbilt Medical Arts Pharmacy
08.2002 - 05.2006
Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.
Answered incoming phone calls and addressed questions from customers and healthcare providers.
Collected co-payments or full payments from customers.
Maintained a clean, organized work environment to uphold quality standards and minimize risk of contamination or error during medication preparation.
Stocked, labeled, and inventoried medication to keep accurate records.
Improved patient satisfaction scores by delivering exceptional customer service in a fast-paced, high-volume pharmacy setting.
Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
Ensured compliance with federal and state regulations by maintaining meticulous documentation of controlled substances and adhering to strict safety protocols.
Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
Reviewed and verified customer information and insurance provider information.
Optimized workflow processes to maintain accurate prescription records and ensure timely order fulfillment for patients.
Supervised [Number] pharmacy technicians and coordinated day-to-day assignments.
Answered patients' questions and troubleshot prescription issues.
Resolved non-routine issues like third-party billing, computer system, and customer service issues.
Counted, measured, and compounded medications following standard procedures.
Maintained relationships with physicians.
Maintained proper drug storage procedures, registries, and records for controlled drugs.
Prepared bottle labels.
Streamlined insurance billing procedures to expedite claims processing while reducing errors related to inaccurate coding or incomplete information submission.
Maintained and updated patient records, prescription information and patient data in accordance with HIPAA regulations.
Set up and modified patient profiles in [System] to include current information such as medications and insurance details.
Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
Resolved third-party billing, computer system and customer service issues.
Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
Coordinated verification and filling of more than [Number] daily prescriptions in high-volume [Type] pharmacy environment.
Managed opening and closing duties for pharmacy.
Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
Developed and implemented improvements to pharmacy organization system.
Liaised with other pharmacies to eliminate issues related to product expiration.
Set up and modified patient profiles to include current medications and insurance details.
Welcomed customers to pharmacy and answered questions relating to prescriptions and over-the-counter products.
Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
Precisely measured and combined ingredients to deliver scrupulous formulation on customer compound prescription orders.
Certified Pharmacy Technician
Diabetes Direct
01.2000 - 08.2001
Made sure our diabetic patients received their insulin and supplies via mail
Took orders from physicians and sent them to the pharmacy to be filled
Made sure patient's address and insurance were updated and correct
Education
High School Diploma -
Coffee County High School
Manchester, TN
05-1990
Skills
Claims processing
Insurance verification
Data recording
Client service
Copay collection
Eligibility verification
Commercial insurance
Medicare
Medicaid
Customer service
Problem-solving
Time management
Attention to detail
Problem-solving abilities
Reliability
Excellent communication
Organizational skills
Effective communication
Verbal and written communication
Decision-making
Certification
Certified Pharmacy Technician since 1998
Licensed with the State Board of Pharmacy
Around 35 years of pharmacy experience since high school.