Bill Waxman Email & Phone Number

Phoenix, Arizona, United States

* Reviewed Medicare Part D/B and commercial Prior Authorization episodes for clinical/plan appropriateness.* Created/updated prior authorization job aides to improve training and accuracy.* Assisted in the processing of Re-determinations and Direct Member Reimbursements for Medicare Part D.

Tucson, Arizona, United States

* Performed therapeutic decision activities related to coverage determination and redetermination requests for AZ Medicaid (AHCCCS), ALTCs and Medicare Prior Authorization claims.* Created/updated Prior Auth. criteria, policies and procedures to increase safety & profitability.* Conducted Drug Utilization Review analyses to discover trends & devise interventions to reduce errors.

Phoenix, Az

* Reviewed and prepared over 70 Prior Authorization Requests daily to prepare files for further review by attending pharmacist.* Utilized problem solving and applied policies and procedures in PA evaluations to ensure accuracy and timeliness adhering to company and government regulations. * Exceeded all metrics while overseeing other technicians during weekend hours.

Scottsdale, Az

* Provided Quality Control and review of paper pharmacy claims, meeting high productivity and quality standards. Review and revise departmental procedures for Medicare Part D/CMS compatibility. * Created innovative methods of tracking claims and procedures resulting in reduced department Auto Forwards by 50% over 1 year period.* Used RxClaim, MedHok and other programs for claims review and formulary management.

Awhatukee, Az

* Process manual pharmacy claims, meeting productivity and quality standards. Verify eligibility of member and status of accounts. * Answer claims questions from internal departments, clients or members; handle escalated issues, receiving, sorting and distributing mail within the department; and filing claims. * Use of RxClaim for claims adjudication and formulary management.

Glendale, Az

* Managed investment, insurance and other financial agents country-wide. Responsibilities include contract management, product knowledge, license training, accounting and interactions with multiple financial entities.* Managed internal processes and agent interactions, as well as client satisfaction initiatives.* Determined quick and effective resolutions to client related issues and streamlined internal processes, resulting in a 40% reduction in response time for customer inquiries.* Reviewed client financial statements and goals to match appropriate products and time frames. * Managed daily on-demand requests for essential services operations while overseeing the training and recruiting of new business and sales-force. Oversee new contracts in excess of $1.5M annually.

Doctor Of Pharmacy - Pharmd, Pharmaceutical Marketing And Management

Activities and Societies: Kappa Epsilon - Member since 2015 APhA-APPM - Member since 2015

Bachelors Of Arts, Psychology

Activities and Societies: Psi Chi - Psychology Honors Society

Mba, Specialization; E-Business