Licensed Pharmacist with 5 years of experience across community and clinical pharmacy, currently working as a Pharmacist and Medical Virtual Assistant supporting U.S. medical insurance claims operations. Highly experienced in reviewing medical and pharmacy prior authorization tickets and providing clinical recommendations for approval, denial, or partial denial based on evidence-based guidelines and payer policies. Skilled in direct communication with U.S. physicians, nurses, and clinic staff to verify patient information and request additional chart notes to support accurate claim determinations. Proven collaborator working closely with U.S. pharmacists, physicians, and executive leadership to ensure regulatory compliance, clinical accuracy, and timely claim resolution.
