Open To Work
Amy Kasyan
Bethel Park
Summary
Dedicated Pharmacy Technician with a strong focus on Medicare and Medicaid processes. Proven track record in claim resolution and staff training, enhancing team performance in fast-paced environments. Committed to maintaining patient confidentiality and compliance, while driving operational improvements and exemplary customer service.
Overview
14
14
years of professional experience
Work History
Sr Medicare Pharmacy Coordinator
Highmark Wholecare
Pittsburgh
03.2017 - Current
- Addressed complaints and grievances related to pharmacy network for Medicare members.
- Collaborated with physician and pharmacy network providers to address needs of providers and plan members efficiently.
- Prioritized requests for drug authorizations or denials to streamline operations.
- Reviewed prior authorization criteria for drug products to ensure compliance and accuracy.
- Facilitated information exchange with doctors' offices via telephone, fax, and email.
- Implemented processes alongside staff to enhance problem-solving capabilities.
- Acted as liaison between physicians, pharmacists and other health care professionals when necessary.
Certified Pharmacy Technician
GATEWAY HEALTH PLAN
Pittsburgh
02.2017 - Current
- Examined physician request forms and records to determine insurance coverage for medications requiring prior authorization, facilitating timely access to necessary treatments.
- Retrieved information from physicians' offices to complete prior authorizations for members, meeting necessary time frames per CMS guidelines and regulations.
- Verifying Continuation of Benefits, Explanation of Benefits for Medicare members in PA, OH, KY, NC.
- Reviewing retail Pharmacy claims along with third-party prescription processing.
- Monitored work productivity and quality, ensuring adherence to standard operating procedures and maintaining operational integrity.
- Maintain HIPAA compliance with all PHI that comes within my work flow.
- Analyze clinical data using appropriate tools.
- Experienced navigation of Microsoft Word, Medhok, CVS, Gatenet, Onbase, and PowerQue.
Certified Pharmacy Technician
RITE AID PHARMACY
Monongahela
08.2012 - 02.2017
- Receive written prescription or refill requests and verify that information is complete and accurate.
- Assisted pharmacists in preparing prescription medications for distribution.
- Maintained inventory levels of pharmaceutical supplies and medications.
- Operated pharmacy software to manage patient records and prescriptions.
- Managed inventories, rotated stock, removed expired, or damaged drug products and resolved discrepancies in drug counts.
- Ensured safe storage and security of drugs to protect their integrity and effectiveness.
- Executed Medicare and Medicaid procedures to ensure proper reimbursement for services.
- Prepare and process medical insurance claim forms and records.
- Received and stored incoming supplies, verified quantities against invoices, and ensured integrity of inventory through diligent checks for outdated medications.
- Emphasized accuracy and efficiency to enhance workflow and service delivery.
- Assisted customers by answering inquiries, locating items, and facilitating referrals to pharmacists for detailed medication information.
Education
National Pharmacy Technician Certification -
01-1997
Pennsylvania Pharmacy Technician Certification -
01-1997
High School Diploma -
BELLE VERNON AREA HIGH SCHOOL
Belle Vernon, Pennsylvania01-1987
Skills
- Medicare and Medicaid expertise
- Medication therapy management
- Pharmacy operations
- Insurance billing
- Problem-solving skills
- Regulatory compliance
- Drug safety regulations
- Formulary management
- Pyxis system
- Workflow Optimization
- Quality improvement
- Strong clinical background
- Team Leadership
- Staff training
- Strong decision-making ability
- Problem-solving skills
- Time management
- Detail-oriented
- Software navigation
- Hospital and retail pharmacy professional
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
RemoteSalary Range
$53000/yr - $200000/yrTimeline
Sr Medicare Pharmacy Coordinator
Highmark Wholecare
03.2017 - Current
Certified Pharmacy Technician
GATEWAY HEALTH PLAN
02.2017 - Current
Certified Pharmacy Technician
RITE AID PHARMACY
08.2012 - 02.2017
National Pharmacy Technician Certification -
Pennsylvania Pharmacy Technician Certification -
High School Diploma -
BELLE VERNON AREA HIGH SCHOOL