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Work experience

June 2017Present

BlueCard Home Claims Examiner

BlueCross BlueShield of Tennessee

As a Claims Examiner, I am responsible for processing BlueCard Home claims from multiple lines of business with individual plans and their own unique guidelines in a timely manner. This sometimes requires communicating with other Host departments within the association as well as escalating issues or questions to a TTE or supervisor as needed to ensure accurate application of benefits and minimization of errors. In addition to general BlueCard participating plans, I am also trained to handle dedicated accounts and BlueCare Claims to their present standards.

Aug 2010May 2017

Discharge Pharmacy Technician

Erlanger Pharmacies, Inc.(formerly Moore & King), Chattanooga, TN

Receiving national certification in October of 2010, my original Clerk position transferred to a traditional Pharmacy Technician role which I fulfilled at 3 different store locations. In January of 2013, I was accepted to be a part of our Bedside Delivery Program as a Pharmacy Liaison for Erlanger Medical Center building a program in effort to decrease hospital readmissions.  In this position I had several opportunities to be involved in more nontraditional aspects of pharmacy such as:

  • Acting as a readily available personal liaison to the pharmacy for patients as well as hospital staff including  physicians, nurses, case management, hospitalist, and respiratory techs within our teaching hospital. This included developing presentations, training materials, and marketing aides catered to individual departments.
  • Trouble shooting patient's proposed home medications before discharge to address any insurance issues such as non-formulary drugs or those requiring prior authorizations as well as ensuring that the patient leaves with an affordable maintenance regimen they can continue.  
  • Utilizing discounted prescription prices for uninsured discharge patients thru the 340B program while helping ensure correct inventory is used to help build additional credits.
  • Researching and proposing comparable medication alternatives to hospital staff as needed to meet cost or insurance requirements .
  • Working with Erlanger's Case Management team to request payment assistance for indigent care patients to reduce readmission within 30 day window.
  • Maintaining documentation records and submitting needed information to accounting department for patient assistance provided.
  • Exploring manufacturer patient assistance and coupon/voucher programs to maintain current knowledge of those available to help patients and the hospital financially.
  • Presenting to and working with medical residents providing education on less common or specialty drugs. Also, educating on state laws, insurance audit issues, and writing to ensure accurate pharmacy dispensing to avoid issues for patient and physician after discharge
  • Meeting with hospital administration and/or specific departments to develop protocols and guidelines for discharging patients often detailed to specific unit requests to better fit their workflow which allowed us to more than double our case load within approximately 2 years.
  • Developing relationships with various drug reps to keep abreast of new drugs available for prescribing that would meet patient needs.
  • Working very closely with Erlanger's Care Transitions team to help promote their mission of optimizing care for Medicare patients and minimizing financial penalties to the health system by reducing readmissions in this group.  This sometimes required extra effort and coordination as issues developed after patient had been discharged for some time.
  • Training new CPhT’s, as well as Pharmacists, as our case load expanded requiring more team members as well as aiding in relationship building between new team member and all referral sources.
Jul 2010Aug 2010

Hostess

Cracker Barrel Country Store, Chattanooga, TN

Greeting restaurant patrons with upbeat friendly attitude and seating according to server's workloads in designated areas ensuring speedy service to maximize customer satisfaction.  

Apr 2007Apr 2008

PRN Medical Assistant

Center for Comprehensive Medicine, Chattanooga, TN

Acting as a team member in a fast paced physician's office,in both clerical and clinical aspects, to maintain timely flow of patients for physicians while cultivating a caring and supportive atmosphere for patient.  Clerical and clinical experience gained by:

  • Scheduling patient appointments according to their personal needs and scheduling guidelines requested by appropriate physician.
  • Assisting patients via phone with questions and concerns or directing to appropriate staff member if additional assistance is needed.
  • Checking patients in upon arrival, verifying/updating current personal information, and obtaining insurance billing information as well as any required documents and/or signatures.
  • Obtaining patients vitals, placing patient is rooms according to physician request to expedite flow, ensuring thorough up to date health and medication records by entering into patients electronic medical record while in room, and documenting any and all patient concerns to be addressed during visit.
  • Assisting physicians with minor surgical procedures in office.
  • Performing additional in office tests and labs as requested.
  • Providing patient with copies of all prescriptions or calling in verbally to patient's pharmacy as well as addressing any issues with medications such as prior authorizations.
Dec 2001May 2006

Shift Supervisor/Pharmacy Technician

CVS Pharmacy, Trenton, GA

I began my employment period as a Cashier and Photo Lab Associate, later earning a promotion to Shift Supervisor, and additionally spending time working both front store and as a Pharmacy Technician.

Responsibilities included:

  • Customer service at checkout and photo lab to include operating register, answering phone calls, maintaining knowledge of current promotions, stocking merchandise, developing photos, and addressing customer issues and complaints to ensure optimal customer satisfaction.
  • Opening and/or closing store while managing 2 to 5 employees on average.
  • Submitting weekly order for store to maintain appropriate inventory.
  • Organizing displays for special promotions.
  • Making weekly store schedules for approximately 5 to 10 employees.
  • Completing daily deposits for store.
  • Working all aspects of pharmacy filling process including drop off, data entry, dispensing drugs, and customer pickup.
  • Neatly filing all paperwork required to be stored on location according to law and store guidelines.
20032003

Sales Associate

Jockey International, Inc
20012002

Receptionist

David Wood Ministries, Trenton,GA

Performed basic receptionist/secretarial duties including:

  • Answering phones and directing calls to appropriate department.
  • Accepting and processing telephone orders.
  • Maintaining neat filing system for customers and their accounts.
  • Entering and updating current customer information in company database.
  • Organizing both large small mailing projects. 

 

 

 

 

 

Education

Aug 2012Dec 2012

Chattanooga State 

Chattanooga, TN

Courses towards Associates Degree in Registered Nursing 

Aug 2004May 2005

Northwestern Technical College

Rock Springs, GA

Courses towards Licensed Practical Nurse Associates Degree

Jan 2004May 2004

Dalton State College

Dalton, GA

Undergraduate courses towards degree in Early Childhood Education

Aug 2003Dec 2003

North Georgia College and State University

Dahlonega, GA

Undergraduate courses toward degree in Early Childhood Education

Certifications

Oct 2010Present

Certified Pharmacy Technician

PTCB

National certification to work as a CPhT





















References

Available upon request.