CONFIDENTIAL RESUME | |
| | PHARMACY AUDIT AND RECOVERY SUPERVISOR |
| |
|Objective |
|To obtain a management position in an organization focused on providing full benefit management components, a company where my |
|industry experience in both a knowledge worker as well as a supervisory position will provide an exceptional fit. |
|Skills Profile |
|Over ten years of building incremental skills in Health Care coverage and Pharmacy Audit and Recovery functions, from the ground |
|floor of the unit’s development through to my current Supervisory position. Especially skilled as a liaison both within the |
|organization as well as with outside vendors. |
|Extraordinary expertise in and an in depth understanding of claims functions, Medicare Part D, collections billing, coordination |
|of benefits, and the myriad of processes which support the ever changing requirements of quality benefit activities. Proven |
|ability to analyze processes, identify issues and support changes while interfacing with a variety of management levels and user |
|groups. |
|Achieved or exceeded department’s savings and recovery goals consistently since the department’s inception. |
|Employment History |
| | |
|2007 – Present Health Net Pharmaceutical Services |
|Supervisor, Audit & Recovery Department |
|Supervise staff of up to 10 associates. |
|Project manager/ Account Manager |
|Preparing and analyzing financial statements/reports |
|Prepare weekly recovery cash deposit reports using checks and balances |
|Perform bi-weekly reconciliation for various lockboxes |
|Prepare checks and balances for all accounting |
|Responsible for setting department recovery goals, forecasts based on current trends, and ambitious goals. |
|Accounts receivable/payable (process payments, overpayments, re-class, reconciliation) |
|Wrote official department policies and procedures as needed. |
|Developed extensive experience in claims adjudication. |
|Responsible for training staff on new policies, with a focus on Medicare Part D. |
|Responsible for writing department policies and procedures.
