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Click here or scroll down to respond to this candidateCandidate's Name , PTCB(Denison, TX)Summary:Angela has 10+ years of experience as a Certified Pharmacy Technician, Housekeeper, Certified Sterile Compounding Pharmacy Technician, Certified IV Pharmacy Technician and Pharmacy Buyer/Lead Pharmacy Technician.Experienced in track and triage all coverage determination requests for prior authorizations and Medicare, Medicaid and/or Exchange (marketplace), Part D or Part B recipientsProficient in obtaining verbal authorizations and request detailed clinical information from prescribersCreating IV infusions in a clean room setting using aseptic technique, a process that allows the end medication to be sterile enough for injection into the patient.Handle lead line calls, coach support and click to chat, specialty lead box emails, and customer complaints.Education:Pottsboro High School - Pottsboro, TX May 2001High school diploma in General StudiesSkills:Ordering medications (3 years)Lead Technician (4 years)Answering Phones (10+ years)Compounding Medications Sterile and non-Sterile (10+ years)Hospital Experience (10+ years)Order Entry (2 years)Pharmacy Technician Experience (10+ years)Typing (10+ years)Order Fulfilment (10+ years)HIPAA (10+ years)Microsoft Word (10+ years)Aseptic Technique (10+ years)Packaging (10+ years)Quality Assurance (10+ years)English (10+ years)Customer service (10+ years)Pharmacy software (10+ years)Basic math (10+ years)Microsoft Excel (4 years)Microsoft PowerPoint (3 years)Time management (10+ years)Certifications and Licenses:PTCB CertificationNovember 2004 to November 2023Registered Pharmacy TechnicianAugust 2006 to January 2023IV Technician Certification April 2007 to December 2037Professional Experience:Sams Club Sherman, TX Jun 2022 to Aug 2022Certified Pharmacy TechnicianRetail services, filling prescriptions, stocking and inventory, answering phones, order entry, purchasing.Track and triage all coverage determination requests for prior authorizations and Medicare, Medicaid and/or Exchange (marketplace), Part D or Part B recipientsTrack and triage coverage determination requests submitted from providers and determine if a pharmacist review is requiredObtain verbal authorizations and request detailed clinical information from prescribersApprove coverage determination requests based on defined criteriaEnter and document coverage determination request decision into the PBM system and notify providers and/or membersRespond to client inquiries regarding authorization approvals and PBM on-line applicationsRefer coverage determination requests for specialty drugs to delegated vendor or client for processingContact providers for additional information to facilitate coverage determination reviewsNotify physicians, providers and members of coverage determination request decisions.Contact physicians for prescription clarification and may enter prescription orders into the system.Also supports Pharmacists and Patients by ensuring adherence to specialty prescription specific operational processes and programs developed to optimize health outcomes, which includes effective communication with patients and providers.Top to Bottom Cleaning Service Denison, TX Jan 2022 to Jun 2022HousekeeperCleaning Residential Homes and Air BnB homesSome local businessesCleans and sanitizes hotel and guest rooms.Vacuums and sweeps floors, carpets, and rugs. Makes beds and changes linens.Cleans and sanitizes bathrooms, showers, toilets, sinks, and countertops. Replenishes toiletries and towels.Pet Script - Paris, TX Jul 2020 to Dec 2021Certified Sterile Compounding Pharmacy TechnicianPrepared nonsterile to sterile medication compounds. Ophthalmic ointments, drops and IM injections.Creating IV infusions in a clean room setting using aseptic technique, a process that allows the end medication to be sterile enough for injection into the patient.Properly use all equipment in the lab that is necessary to make both sterile and non-sterile compounds, following all safety and USP guidelines for preparation of compounded medications.Daily monitoring and recording of non-sterile refrigerator, freezer, and lab temperatures, and humidity into Simplifi 797; as well as monitoring and recording sterile clean-room temperature, humidity, and non-hazardous pressure differential testing.Fully trained in aseptic technique and USP <797>, assuming lead position in sterile compounding department including the training of new employees.Maintaining pharmacy inventory and supplies, as well as ordering from wholesalers.Interacting professionally and efficiently with patients while upholding HIPAA standards.Wilson N. Jones Regional Medical Center - Sherman, TX Nov 2018 to Jul 2020Certified IV Pharmacy TechnicianPrepared all intravenous admixture for the ER, Surgery and 24 hour regimens for all other inpatients. As well as TPNs, Emergency Stroke medications and Replacement fluids (prisma).Organizes medications for pharmacist to dispense by reading medication orders and prescriptions, preparing labels, calculating quantities, and assembling intravenous solutions and other pharmaceutical therapies. Maintains records by recording and filing physicians' orders and prescriptions.Preparing new prescription and refill requests for patients.Dispensing medication to patients per the prescription, or provider's orders.Packing and labeling a prescribed medication.Processing insurance claims.Tracking inventory.Wilson N Jones Hospital - Sherman, TX Nov 2015 to Jul 2018Pharmacy Buyer/Lead Pharmacy TechnicianLead technician over all other technicians. Involved schedule making and making sure the day to day operations of the main pharmacy ran smoothly. Also, all the daily medication and supply ordering. Filled in when there were gaps that could not be covered by the staff technicians.Facilitates cross-functional resolution of drug coverage issues.Facilitates escalated orders to ensure medication issues are resolved and customers receive necessary medication in a timely manner.Provide expert assistance to internal and external clients on patient status.Contacts benefit providers to gather policy benefits/limitations.Performs medical and pharmacy benefit verification requiring complex decision skills based on payer and process knowledge.Handle escalations with expert understanding on department policies and procedures.Prepares and reviews claims to ensure accuracy to payer requirements, including but not limited to codes, dates, and authorizations.Coordinating and ensuring services provided will be reimbursable.Initiate prior authorization requests as needed to obtain required approvals.Pharmacy managing complex and chronic health conditions through personalized care, pharmacy delivery and more.Maintaining records by recording and filing the prescriptions and orders of PhysiciansResponding to the requests of patients and healthcare providers, answering their questions, and referring various inquiries to the PharmacistProcessing prescriptions electronically and ensuring all information is accurate and completeGenerating revenues by calculating and issuing chargesRecording keeping, returns, credit requests, claim repossession, release credit holds, revise ledger and adjustments, and unlock order requests.Handle lead line calls, coach support and click to chat, specialty lead box emails, and customer complaints.Manage medication resend requests. |
