Lequita Grier
Concord
Summary
Patient-focused professional with strong administrative and customer service skills. Coordinates communications, referrals, and policy enforcement to ensure seamless healthcare operations. Proven ability to identify balanced solutions and effectively resolve conflicts.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Pharmacy Customer Care Specialist
Capital Rx
09.2025 - Current
- Handle inbound and outbound calls from members, providers, and pharmacies regarding prescriptions, benefits, and claim statuses.
- Intake requests, ask clinical questions, and escalate to the clinical team for prior authorizations.
- Advise on options for formulary exceptions, copays, early refills, etc., based on plan design.
- Assist pharmacies with adjudication errors and resolve claim issues.
- Identify medications requiring special handling, such as refrigerated medications.
- Accurately document and update information in databases.
- Serve as a point of escalation for other Customer Service Representatives and route complex issues to appropriate teams, including Operations and Clinical.
- Collaborate with internal teams, such as Clinical, Finance, and Operations, to address systemic issues.
- Follow HIPAA guidelines and company policies to ensure compliance.
Lead Pharmacy Technician
Walmart Pharmacy
02.2008 - Current
- Supervise daily pharmacy workflow to meet productivity, quality, and service-level targets.
- Lead benefits verification, insurance claim submission, rejection resolution, and eligibility validation.
- Monitor quality assurance metrics, turnaround time, and compliance with payer and HIPAA standards.
- Train, coach, and mentor pharmacy technicians on claims processing, prior authorizations, documentation accuracy, and patient communication.
- Support hiring, onboarding, and performance development of technicians.
- Identify workflow inefficiencies and implement process improvements to reduce claim rework and financial loss.
- Serve as escalation point for complex insurance issues, payer disputes, and high-priority patient concerns.
- Support revenue performance, patient satisfaction, and audit readiness.
Pharmacy Technician II
Novant Health
04.2024 - 12.2024
- Maintained inventory levels and conducted regular stock assessments.
- Dispensed medications accurately to patients and healthcare providers.
- Prepared compound medications under the supervision of a licensed pharmacist.
- Maintained Epic EHR documentation to support regulatory compliance and billing accuracy.
- Prepared sterile intravenous medications using aseptic techniques and proper protocols.
Patient Service Specialist II
AmerisourceBergen
08.2022 - 04.2024
- Conducted benefit investigations for specialty medications.
- Processed insurance claims, prior authorizations, and claim rework.
- Resolved rejected and pending claims through eligibility verification and payer coordination.
- Served as liaison between patients, providers, and insurance carriers.
- Analyzed claim trends to improve first-pass payment accuracy.
Data Entry Pharmacy Technician
Optum Health
12.2021 - 02.2022
- Entered and validated prescription and insurance data for large-scale claims processing.
- Assisted with audit preparation, claim rework, and compliance monitoring.
Education
Master of Science - Health Care Administration
University of Phoenix
Phoenix, AZ04-2026
Bachelor of Science - Health Care Administration
Purdue University
West Lafayette, IN04-2022
Skills
- Benefits verification and eligibility review
- Claims adjudication and reimbursement resolution
- Prior authorizations and coverage determination
- Workflow management and production metrics
- Team supervision and staff training
- Hiring and onboarding processes
- Performance management and quality assurance
- HIPAA compliance and call volume reporting
- Customer service excellence
- Process improvement strategies
- Specialty and retail pharmacy operations
Certification
- Certified Pharmacy Technician (CPhT - PTCB)
- North Carolina Pharmacy Technician License
Accomplishments
- Boosted Productivity, Increased pharmacy productivity by 20% through process improvements and workflow optimization.
- Claim Rework Reduction, Reduced claim rework by 25%, saving $50,000 annually through new verification protocols.
- Enhanced Team Efficiency, Trained 30+ technicians, improving team efficiency and service delivery metrics by 15%.
- Insurance Issue Resolution, Resolved 98% of complex insurance issues on first attempt, improving patient satisfaction scores by 30%.
Timeline
Pharmacy Customer Care Specialist
Capital Rx
09.2025 - Current
Pharmacy Technician II
Novant Health
04.2024 - 12.2024
Patient Service Specialist II
AmerisourceBergen
08.2022 - 04.2024
Data Entry Pharmacy Technician
Optum Health
12.2021 - 02.2022
Lead Pharmacy Technician
Walmart Pharmacy
02.2008 - Current
Master of Science - Health Care Administration
University of Phoenix
Bachelor of Science - Health Care Administration
Purdue University