Lakisha Dargin

Waldorf,MD

Summary

Results-driven healthcare professional with more than 20 years of experience supporting reimbursement, patient access, pharmacy operations, and insurance navigation across ambulatory, outpatient, inpatient, specialty, and government healthcare settings. Extensive expertise in prior authorizations, benefit investigations, insurance verification, payer policy interpretations, medication access support, and reimbursement issue resolution. Proven ability to collaborate with providers, patients, specialty pharmacies, and payer organizations to facilitate timely access to therapies while ensuring compliance with regulatory and payer requirements. Recognized for strong relationship-building skills, problem-solving abilities, and expertise navigating complex healthcare reimbursement environments.

Overview

Certification

years of professional experience

Work History

AMBULATORY PHARMACY TECHNICIAN II /Prior Authorization Specialist

PAMF - Sutter Health

Los Altos, CA

07.2024 - 06.2026

Manage complex prior authorization requests for physician-administered and specialty medications across Commercial, Medicare, and Medicaid health plans.
Processed 30 prior authorization requests daily, ensuring timely approvals for patient access to necessary medications.
Conducted insurance verification and eligibility reviews to confirm patient coverage and streamline authorization processes.
Process incoming faxes related to prior authorization requests and ensure timely routing for review and resolution.
Work in a high-volume call center environment handling 40–50 inbound and outbound calls daily.
Supported Utilization Management by reviewing authorizations and collecting documentation for efficient case resolution.
Collaborate with providers, specialty pharmacies, and payer organizations to resolve reimbursement barriers.
Navigate payer portals and submit supporting clinical documentation.
Utilize ICD-9, ICD-10, and HCPCS coding.
Assist with appeals and denial resolution.
Maintain authorization records in compliance with organizational policies, payer requirements, regulatory guidelines, and HIPAA.

AMBULATORY PHARMACY TECHNICIAN II

PAMF Sutter Health

Burlingame, CA

02.2022 - 06.2024

Assisted high-volume ambulatory pharmacy operations to ensure effective medication management for diverse patient populations.
Coordinated prescription processing, refill management, and medication access activities.
Served as a liaison among patients, providers, pharmacies, and insurance plans to address medication-related concerns.
Assisted patients with insurance-related inquiries and prescription coverage issues.
Reduced administrative burden on healthcare providers through efficient workflow management and communication.
Maintained strict HIPAA compliance and patient confidentiality standards.
Worked in high volume call center environment handling 40 plus inbound and outbound calls daily.
Supported Utilization Management through authorization review and documentation collection.
Coordinated patient appointments and laboratory testing to meet clinical monitoring requirements, supporting medication adherence, timely refill authorizations, and continuity of care.

Inpatient Pharmacy Technician

ABSMC - Sutter Health

Berkeley, CA

02.2017 - 06.2024

Facilitated pharmacy operations in fast-paced acute care environment, ensuring timely medication delivery and adherence to safety protocols.
Prepared sterile compounded medications, IV therapies, TPNs, and other pharmaceutical products.
Managed medication inventory and automated dispensing systems.
Participated in quality assurance, medication safety, and compliance initiatives.
Trained and mentored new pharmacy technicians and staff members.
Processed more than 300 prescriptions daily in a high-volume pharmacy environment while providing exceptional customer service, maintaining prescription accuracy, resolving insurance issues, and supporting efficient workflow

Education

High School Diploma -

Northwestern High School

Hyattsville, MD

06.1997

Skills

Prior Authorization & Appeals Coordination
Reimbursement Support & Access Management
Benefit Investigations & Coverage Verification
Medicare, Medicaid & Commercial Payer Expertise
Medical Benefit & Pharmacy Benefit Navigation
Insurance Verification & Eligibility Reviews
Specialty Pharmacy Coordination
Patient Assistance & Access Programs
Medication Access & Affordability Solutions

ICD-9, ICD-10 & HCPCS Coding
Epic EHR, Pharmacy Systems & Workflow Optimization
Electronic Prior Authorization Platforms & Insurance Portals
HIPAA Compliance & Regulatory Adherence
Cross-Functional Collaboration & Relationship Management
Microsoft Office Suite
Pyxis
KitChek
Pharmacode