OBJECTIVE:

To seek a position where I can utilize my 11+ years progressive experience and knowledge all while performing well - organized and excellent work that will enable me to deliver promising work at your company.

SUMMARY:

• Immense ability to work independently under pressure
• Professional demeanor
• Able to do all duties as assigned
• Exceptional communication and leadership skills
• Enormous tenacity to meet deadlines
• Excellent organization skills
• Meticulous work ethic
• HIPAA compliant
• Extensive knowledge of medical and pharmacy billing

COMPUTER SKILLS:

• Intelligent Pharmacy Software (IPS)
• Health Business Systems (HBS)
• Rx2000
• CPR+
• PrimeRx
• Windows XP, Windows Vista, Windows 10, MacOS, and Linux
• MS Word, Excel, Power point, Access, and Outlook
• Excellent Internet and Web 2.0 skills
• All major web browsers

PROFESSIONAL EXPERIENCE:

Intake and Prior Authorization Department Supervisor / Regional Account Executive

Confidential, Melville, NY

Responsibilities:

• Serving as the Intake and PA Department Supervisor while overseeing multiple employees and processes on a daily basis in order to preserve the company twenty-four-hour turnaround time
• Operating as the primary contact for receiving phone calls, emails, and faxes from all company accounts along with pharmaceutical representatives
• Coordinating with third party Insurance Companies for medical and pharmacy benefits, prior authorizations, and pharmacy appeals on behalf of the prescribing physician
• Obtaining copay assistance for any patient with financial difficulty through dozens of non-profit agencies country wide
• Communicating with the both Principles of the Company and all Department Managers regarding any information received from the physicians, insurance companies or employees about customer's care or needs
• Using discretion and independent judgment in handling customer complaints received, while documenting and forwarding to appropriate administrative staff
• Ensuring that all prescriptions were billed in accordance with Confidential regulations and that all required information was documented on the hardcopy prescription
• Performing seamless transfers of prescriptions to designated Mail Order Specialty Pharmacies when needed, and also performing daily related follow-up.

Billing Department Supervisor / Lead Specialty Pharmacy Technician

Confidential, Bronx, NY

Responsibilities:

• Serving as the Billing Department Supervisor while overseeing multiple employees and processes on a daily basis in order to preserve the company twenty-four-hour turnaround time
• Acting as the sole company wide Urology Outside Sales Representative for all five boroughs, Long Island, and Upstate New York
• Operating as the primary contact for receiving phone calls, emails, and faxes from over twenty Urology, Oncology, and Nephrology accounts along with pharmaceutical representatives
• Coordinating with third party Insurance Companies for medical and pharmacy benefits, prior authorizations, and pharmacy appeals on behalf of the prescribing physician
• Obtaining copay assistance for any patient with financial difficulty through dozens of non-profit agencies country wide
• Communicating with the President of the Company and Specialty Pharmacy Benefit Managers regarding any information received from the physicians, insurance companies or employees about customer's care or needs
• Using discretion and independent judgment in handling customer complaints received, while documenting and forwarding to appropriate administrative staff
• Ensuring that all prescriptions were billed in accordance with Confidential regulations and that all required information was documented on the hardcopy prescription
• Performing seamless transfers of prescriptions to designated Mail Order Specialty Pharmacies when needed, and also performing daily related follow-up.

Clinical Care Coordinator / Indigent Drug Reviewer / Prescription Benefits Reimbursement Specialist

Confidential, Lake Success, NY

Responsibilities:

• Acted as the sole Indigent Drug reviewer for the Confidential product Confidential ®
• Operated as the Internal Copay Assistance reviewer for the Confidential Injectable Department
• Served as primary contact for receiving phone calls from physician offices and pharmaceutical representatives for both the Confidential ® and Confidential ® insurance verification hubs/portals
• Coordinated with third party Insurance companies for Confidential Cancer injectable and OA injectable medical and pharmacy benefits, prior authorizations, and pharmacy appeals on behalf of the prescribing physician
• Communicated with the Director of Prescription Fulfillment Programs and Program Support Specialists regarding any information received from the physician, insurance company or employees about customer's care or needs
• Used discretion and independent judgment in handling customer complaints received, while documenting and forwarding to appropriate administrative staff
• Ensured that all prescriptions were billed in accordance with Confidential regulations and that all required information was documented on the hardcopy prescription
• Ensured the seamless transfers of prescriptions when needed, and performed related follow-up

Pharmacy Technician

Confidential, Ronkonkoma, NY

Responsibilities:

• Served as a pharmacy technician preparing medications according to the pharmacy’s standards-of-quality-guidelines and government regulations
• Performed daily and monthly inventory control, incorporating Efficient Inventory Management (EIM) principles contributing to improved cash flow, good customer service, and more accurate prediction of future needs. This involved conscientiously assuring that all expired and recalled medications were removed from stock, keeping accurate counts, accurately entering the data into the computer system, receiving and restocking all needed supplies
• Responded to customer inquiries, addressing questions or requests by phone and/or email

Pharmacy Technician

Confidential, Wading River, NY

Responsibilities:

• Performed as a pharmacy technician and a customer service representative in all areas of the pharmacy
• Responsible for assisting licensed pharmacists with clerical duties associated with managing the pharmacy
• Established and maintained patient profiles, including lists of medications taken by individual patients
• Assisted customers by answering simple questions, locating items and referred any questions regarding prescriptions, drug information, or health matters to a pharmacist
• Coordinated information with insurance companies
• Received written prescription requests from patients, prescriptions sent electronically from doctors’ offices, and by phone
• To prepare the prescriptions, I retrieved, counted, poured, weighed, measured, and sometimes mixed the medications. Then I prepared the prescription labels, select the type of container, and affix the prescription and auxiliary labels to the container
• Referred any questions regarding prescriptions, drug information, or health matters to a pharmacist