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@tiffanyward
Results-driven Pharmacy Operations and Insurance Specialist with extensive experience.
I am a highly motivated professional with extensive experience in pharmacy operations and healthcare management. My career has been defined by a proven track record in managing insurance verifications and building strong relationships with healthcare providers. I excel in driving revenue growth while maintaining regulatory compliance and delivering exceptional customer service in fast-paced environments.
Currently, I serve as a Pharmacy Prior Authorization Specialist at Onco 360, where I manage and process prior authorization requests for oncology and rare disease medications. My role involves coordinating with insurance companies and physicians to expedite approvals and resolve denials, ensuring timely treatment authorization for patients. I take pride in maintaining accurate patient profiles and ensuring full HIPAA compliance, which is crucial in our industry.
Previously, I worked as a Pharmacy Operations and Insurance Specialist at Scripts RX Pharmacy, where I delivered superior customer support and managed insurance verifications. I played a key role in streamlining operations and improving medication affordability through patient savings programs. My experience also includes managing pharmacy operations at Allied Pharmacy, where I significantly contributed to scaling the pharmacy’s revenue from $25,000 to $1.5 million in gross monthly profit within the first year of operation.
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Work history, roles, and key accomplishments
Onco 360
May 2025 - Present (6 months)
Managed and processed prior authorization requests for oncology and rare disease medications, coordinating with insurance companies and physicians to expedite approvals and resolve denials. Proactively handled authorization expirations and appealed denials when necessary, ensuring timely treatment authorization and HIPAA compliance.
Scripts RX Pharmacy
Mar 2024 - Present (1 year 8 months)
Delivered superior customer support by managing insurance verifications, assisting patients with payment follow-ups, and clarifying prescription-related inquiries. Coordinated with healthcare providers to obtain new prescriptions or resolve ambiguities, ensuring accuracy and compliance while also handling prior authorization processes to expedite medication access.
Allied Pharmacy
Jan 2023 - Present (2 years 10 months)
Managed daily pharmacy operations, ensuring seamless workflow and compliance with regulatory standards, and built strong relationships with healthcare providers by coordinating with doctors' offices to obtain clinical records for prior authorizations. Played a key role in scaling the pharmacy’s revenue from $25,000 to $1.5 million in gross monthly profit within the first year of operation.
UPI Builders LLC
Mar 2019 - Present (6 years 8 months)
Managed administrative operations, including payroll processing, purchasing, and employee onboarding. Provided excellent front office support, including answering phones and greeting visitors to maintain smooth office operations.
Kohl's
Jul 2017 - Present (8 years 4 months)
Delivered outstanding customer service, consistently achieving daily sales targets. Maintained store organization and ensured accuracy of promotional signage and displays.
Self Employed
Jan 2014 - Present (11 years 10 months)
Focused on managing household responsibilities while nurturing and raising a child. Developed excellent organizational, multitasking, and time-management skills during this period.
Degrees, certifications, and relevant coursework
Certificate, Cancer Data Management
2023 -
Currently enrolled in a Cancer Data Management program. This course focuses on the principles and practices of managing cancer-related data.
Associates, Healthcare Administration
2023 -
Currently pursuing an Associate's degree in Healthcare Administration. This program is enhancing my knowledge in healthcare management and administrative practices.
High School Diploma, General Studies
2004 - 2008
Completed high school education and received a diploma.
Software and tools used professionally
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