Pharmacy ~ Medical/Healthcare Administration

  Extensive background specializing in medical/healthcare field, with unique blend of experience as Pharmacy Technician along with career in medical insurance administration

  Expertise in pharmacy operations both in clinical and retail environments; proficient in filling prescriptions and managing stock in compliance with industry regulations

  Diverse insurance knowledge; adept in determining and addressing client needs as critical tool in generating new business, delivering world-class service, building loyalty, and driving revenue growth

  Solid administrative skills ranging from high-volume inbound and outbound phone management, order input/fulfillment, customer assistance, payment processing, insurance billing, and billing discrepancies resolution to inventory control, vendor relations, procurement, and shipping

  Dynamic communication and interpersonal relation skills instrumental to effectively interfacing with clients, vendors, management, and peers, bi-lingual fluency in English and Spanish

  Effectively prioritize and manage projects/workflow to optimize efficiency and productivity in fast-paced, time-sensitive environments

  Proficient in maintaining complex information systems, databases and records as well as preparing/ producing detailed reports; adept in PC operations and diverse systems, software and applications

  Strong work ethic and high level of professional integrity; consistently represent employer in a positive manner and collaborative team player who works well management and staff

Ambulatory Pharmacy Technician, Henry Ford Hospital New Center One-Detroit, MI 2017-Present

  As member of Outpatient Pharmacy team, proficiently support broad pharmacy operations spanning order fulfillment through inventory control and administrative

  Expertly fill physician and hospital prescription orders; includes verifying, counting and labeling as well as entering medication information in patient charts

  Efficiently receive, verify and stock inbound supplies; play solid role in controlling inventory to maintain optimal stock levels and ensure prompt removal of expired drugs

  Productively manage clerical/administrative functions, including managing inbound phone calls and providing quality service to medical professionals and hospital staff members

Engagement Specialist, Blue Cross Blue Shield of Michigan-Detroit, MI 2014-2016

  Proficiently managed referrals for consult with Registered Nurse on health information, symptom management and related issues as well as transferred calls to cross-functional departments/divisions including 24-Hour Nurse Line, customer service and BlueWeb Help Desk along with vendor partners

  Supported cost controls while delivering quality service by educating members on ER alternatives

  Expertly fielded compliance-related inquiries spanning Qualification Form, Blue Points, employee wellness (BWell), health assessments, digital coaching, and wellness coaching; included addressing group compliance as well as member non-compliance inquiries

  Actively assisted members in navigating online resources including bcbsm.com, member portal, online health assessment, and health coaching modules; advised on discounts and opportunities

  Efficiently conducted provider searches and promoted member utilization of Patient Centered Medical Home (PCMH) and Centers of Excellence; received referrals and submitted requests for Case Management services as well as handled Connect 2BFit inquiries

  Successfully marketed and facilitated pre-enrollment processing of Wellness and Care Management (WCM) programs as well as assisted members by scheduling appointments for WCM interventions including Quit the Nic, Chronic Condition Management and Wellness coaching programs; processed referrals from 24/7 Health information line

  Effectively received member phone inquiries generated by automated outbound calling system as well as conducted outbound calls promoting CCP Chronic Condition Management program; provided information and education focused on generating new member participation

Rocio J. Monroy Page 2 of 2

Professional Experience continued

Workers Compensation Auto / PIP Specialist, EHIM-Southfield, MI 2013-2014

  Contributed pharmaceutical/healthcare industry background along with dynamic customer service skills toward delivering customized pharmacy and healthcare benefit services, playing vital role in building and maintaining critical relationships across insurance carriers, third party administrators and self-insured employers

  Employed proprietary claims system to create customized formularies for managing compensation claims from initial fulfillment throughout duration of claim

  Actively supported clinical programs and team members along with case managers and adjusters across channel utilization, dose optimization, adherence, prescribing patterns, trend management, and overall performance management

Pharmacy Technician, Rite Aid Pharmacy-Toledo, OH 2000-2010

Efficiently received, reviewed, clarified, input, and filled customer prescription/refill orders as well as processed payments for prescription and pharmacy-related items; followed up on orders and shipments

Handled high volume inbound and outbound phone calls with physician offices, insurers and customers

Accurately performed extensive computerized data input and retrieval

Worked with varied insurers for billing purposes as well as followed up on issues for prompt resolution

Strategically rotated stock for seasonal adjustments, controlled inventory and placed orders

Associate of Applied Science, Owens Community College-Toledo, OH; 2008

Technician Certification, Owens Community College-Toledo, OH; 2007