Keith Bargemann Cpht Email & Phone Number

Costa Mesa, California, United States

- Complete and submit prior authorization requests to insurance via electronic, fax, or phone- Assist providers in submitting an appeal to overturn a denied prior authorization- Comprehensive knowledge and understanding of insurance criteria used for coverage of specialty drugs (ie. Prolia, Humira, Evenity, Wegovy, Ozempic, Enbrel)- Call insurance to verify major medical benefits for billable CPT codes- Coordinate with the specialty pharmacy to schedule medication deliveries to doctor’s office- 3 years experience using CoverMyMeds to submit electronic PA requests- 3 years experience using Epic in executing my role as CPhT - Follow HIPAA guidelines in all workflows and documentation- Communicate professionally with patients via inbound and outbound call- Follow established protocol in approving or routing Rx refill requests- Clear and thorough documentation when accessing patient chart- Collaborate with colleagues to achieve company goals and initiatives- Maintain a professional demeanor in all administrative and patient care correspondence - Open and willing attitude to expand my knowledge and learn from others- Adaptable to change in workflow and procedures

Orange County, California Area

Works alongside the Pharmacist in performing the following duties in a fast-paced pharmacy setting:- Treat every patient as a priority and provide exceptional customer service at all times- Receive prescriptions at Drop-off and scan into patient's profile- Accurately type prescriptions during Data Entry- Maintain a comprehensive knowledge of sig codes, brand names, and generics- Continually learn of new generics on the market, and check for coverage- Correctly process DAW1 prescriptions- Bill prescriptions to third parties, including Workers Compensation- Medi-Cal and CalOptima billing- Correctly process eTar requests for Medi-Cal patients- TRICARE and VA billing- MEDICARE and MEDICARE PART D billing- Correctly process Detail Written Order (DWO) form requests for MEDICARE patients- Bill medical coverage for pharmacist-administered vaccinations- Bill secondary insurances and coupons via Coordination of Benefits- Resolve Third Party Rejections- Prior Authorizations- Fill and label prescriptions under the direct supervision of the pharmacist- Work with urgency to ensure all prescriptions are filled accurately and on time- Assist with phone calls from patients and Dr.'s office- Demonstrate professional phone etiquette- Fax and call for refill requests and authorizations- Operate the Drive-Thru window and Pickup window- Follow HIPAA guidelines- Maintain correct inventory counts- Check for expired drugs and create claims for expired or excess inventory- Quarantine all recalled products and communicate to manufacturers of any defects- Keep all filling stations neat, clean, and orderly at all times- Keep hazardous, sulfa, or penicillin drugs separate and protected form cross-contamination- Coordinate phone calls with patients regarding company initiatives- Work with patients to boost medication adherence- Resolve Third Party Chargebacks

Orange County, California Area

- Receive prescriptions at Drop-off- Accurately type prescriptions during Data Entry- Maintain a comprehensive knowledge of sig codes- Bill prescriptions to third parties, including Workers Compensation- Correct processing of Medi-Cal and CalOptima claims- Resolve Third Party Rejections- Bill secondary insurances and coupons via Coordination of Benefits- Fill and label prescriptions under the direct supervision of the pharmacist- Assist with phone calls from patients and Dr.'s office- Operate the Drive-Thru window and Pickup window- Follow HIPAA guidelines- Maintain correct inventory counts- Check for expired drugs and create claims for expired or excess inventory- Keep all filling stations neat, clean, and orderly at all times

- Team Leadership- Customer Engagement- Task Management- Cash Handling- Store Operations

- Customer Engagement- Technical and Photography Assistance- Photo Lab Management

Orange County, California Area

- Customer Engagement- Technical and Photography Assistance