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Julia Lopez medina

@julialopezmedina

Prior Authorization Specialist at MedImpact who processed Medicare Part D coverage requests and clinical escalations.

At MedImpact, I reviewed standard and expedited Medicare Part D coverage requests, including prior authorizations, formulary exceptions, step therapy, and quantity exceptions. I checked clinical and plan information against criteria, researched claims, and coordinated with provider offices to complete cases.

At CVS/Caremark, I processed pharmacy and medical prior authorization requests for Medicare, Medicaid, and third-party payer plans. Earlier, at Verdugo Pharmacy Plaza, I supported dose-pack workflows and used Epic and Cerner in pharmacy and clinical settings.

Experience

Work history, roles, and key accomplishments

Prior Authorization Specialist – Medicare Part D

MedImpact

Nov 2025 - Sep 2026 (10 months)

Reviewed standard and expedited Medicare Part D coverage determinations across multiple workflows, validated clinical documentation, and coordinated with providers to complete cases. Handled escalations and final processing while meeting productivity and turnaround-time expectations.

Prior Authorizations Medicare Part D ICD 10 Claims Research Provider communication Case Escalation HIPAA Documentation

Prior Authorization Specialist

CVS/Caremark

Sep 2023 - Oct 2025 (2 years 1 month)

Processed pharmacy and medical prior authorization requests across Medicare, Medicaid, and commercial plans, including standard and urgent workflows. Reviewed eligibility, benefits, and clinical documentation, and communicated with providers to resolve issues.

Prior Authorizations Medicare Medicaid Commercial Plans Claims Research Utilization Management Provider communication HIPAA

Pharmacy Technician – Dose Pack

Verdugo Pharmacy Plaza

Jan 2020 - Aug 2023 (3 years 7 months)

Filled, labeled, and packaged unit-dose medications, verified NDCs and quantities, and maintained inventory. Used Epic and Cerner to support medication-distribution workflows and accurate documentation.

Pharmacy Technician Unit Dose Packaging NDC Verification Inventory Management Epic Cerner HIPAA