Lisa Hahne

Analyzed reports for members engaging multiple pharmacies or physicians for pain management.

Investigated potential hazards of duplicate medications such as blood pressure or psychotropic drugs.

• Examined drug interactions within member prescriptions to mitigate health risks.
• Compiled targeting report and initiated communication with members and providers for transparency.
• Organized feedback from recipients, filing letters into 3- or 6-month review categories.
• Handled returned undeliverable letters by verifying member claims for targeted medications.
• Sourced new addresses via Lexis Nexis and NPPES, employing Google as necessary.
• Distributed investigator-generated letters addressing concerning activities from pharmacies or doctors.

• Type, fill, then sell prescriptions, stock shelves with medications, return out-of-date meds, create schedules and flow charts, contact doctors and insurance companies by phone, and provide customer service.
• Keep up with new drugs and interactions.
• Keep licenses and certifications current with continuing education.

• Determine member eligibility for the current plan year.
• Review the claim and determine if a member has satisfied the prior authorization criteria per Medicare standards or Medicaid, based on the request.
• Make contact with either the provider or the pharmacy for missing information needed to decide whether to approve, deny, or pend for further information.
• Keep current with any changes made to plans, criteria, and check for updates regarding drug status and FDA standings.

• Typed new prescriptions and entered insurance information into member files.
• Processed incoming and outgoing letters, managing fax communications efficiently.
• Utilized scanner and copier for document management and workflow support.
• Engaged in problem-solving to address customer and provider inquiries.
• Conducted phone communications with customers, doctors, and insurance agents.
• Lifted totes of medications while adhering to safety protocols.
• Interviewed customers to identify needs and provide tailored assistance.
• Oversaw inventory management by ordering supplies and reconciling invoices.

• Typed new prescriptions and input insurance information into member files.
  Filed completed scripts and managed incoming and outgoing faxes.
  Operated scanner and copier for document management tasks.
  Communicated with customers, doctors, and insurance companies to resolve inquiries.
  Lifted totes of medications to maintain organization in a fast-paced environment.
  Conducted customer interviews to assess needs and provide appropriate solutions.
  Handled high-volume calls, ensuring timely service at thedrive-thru and counter.
  Managed inventory by ordering drugs, returning outdated medications, and reconciling invoices.

• Processed prescriptions by accurately reading, typing, and filling requests.
  Requested information from medical facilities for California Treatment Authorization Requests.
  Filed completed forms and original orders according to California State Board procedures.
  Faxed prescription requests to medical doctors while safeguarding patient privacy and HIPAA compliance.
  Entered insurance information into patient files to facilitate co-pay processing.
  Generated patient profiles for tax record requests at year-end.
  Sold narcotic prescriptions following identification verification per California drug laws.
  Combined multiple patient files into single records by obtaining necessary information.