Frances Acosta

Verify insurance eligibility and authorization of current and potential clients in an accurate and timely manner.

Monitor monthly the eligibility standing of current agency, Cencal clients.

Communicate Cencal authorization and eligibility information to staff and management.

Review and ensure appropriate processing of authorizations.

Send informational correspondence to Cencal.

Document eligibility and any changes to client authorization and eligibility information.

Enter and track insurance authorization and eligibility information.

Demonstrate self direction to prioritize and accomplish job responsibilities.

Maintain knowledge of Cencal eligibility and remain current with any changes to Cencal eligibility and enrollment.

• Fielded telephone inquiries on authorization details from plan members and medical staff.
• Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
• Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
• Tracked referral submission during facilitation of prior authorization issuance.

• Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.
• Resolved non-routine issues like third-party billing, computer system, and customer service issues.
• Resolved third-party billing, computer system and customer service issues.
• Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
• Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
• Provided excellent customer service at the point-of-sale counter, efficiently managing transactions while addressing patient inquiries.
• Maintained and updated patient records, prescription information and patient data in accordance with HIPAA regulations.
• Welcomed customers to pharmacy and answered questions relating to prescriptions and over-the-counter products.
• Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
• Managed opening and closing duties for pharmacy.
• Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
• Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.

• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Stocked, labeled, and inventoried medication to keep accurate records.
• Boosted customer loyalty by providing friendly, knowledgeable assistance on drug interactions and side effects.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
• Improved patient satisfaction by efficiently processing prescriptions and managing inventory in a timely manner.
• Maximized pharmacy efficiency through effective communication with staff members and adherence to procedures.
• Welcomed customers to pharmacy and answered questions relating to prescriptions and over-the-counter products.
• Provided exceptional customer service, fostering positive relationships with both new and returning patients at the pharmacy counter.
• Coordinated with physicians and insurance agency representatives for speedy resolution of prescription discrepancies.

• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Stocked, labeled, and inventoried medication to keep accurate records.
• Increased overall pharmacy productivity by restocking supplies, organizing shelves, and maintaining cleanliness according to standards.
• Improved patient satisfaction by efficiently processing prescriptions and managing inventory in a timely manner.
• Proactively identified potential issues or discrepancies in medication orders, collaborating closely with pharmacists to resolve them quickly.
• Maximized pharmacy efficiency through effective communication with staff members and adherence to procedures.
• Welcomed customers to pharmacy and answered questions relating to prescriptions and over-the-counter products.
• Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
• Counted and labeled prescriptions with correct item and quantity.
• Streamlined prescription processing with accurate data entry and verification of patient information.
• Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
• Resolved third-party billing, computer system and customer service issues.
• Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
• Entered and processed patients' prescriptions into internal system.
• Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.

• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Demonstrated strong organizational and time management skills while managing multiple projects.
• Developed and maintained courteous and effective working relationships.
• Learned and adapted quickly to new technology and software applications.
• Adaptable and proficient in learning new concepts quickly and efficiently.
• Strengthened communication skills through regular interactions with others.
• Organized and detail-oriented with a strong work ethic.
• Worked flexible hours across night, weekend, and holiday shifts.
• Assisted with day-to-day operations, working efficiently and productively with all team members.
• Demonstrated respect, friendliness and willingness to help wherever needed.
• Worked well in a team setting, providing support and guidance.
• Excellent communication skills, both verbal and written.
• Skilled at working independently and collaboratively in a team environment.
• Worked effectively in fast-paced environments.
• Self-motivated, with a strong sense of personal responsibility.
• Utilized pharmacy management software to process prescriptions efficiently.