Job Search Status
Open to workDesired start date: Immediately
ANGELA BAGGETT
Florissant,MO
Work Preference
Summary
- Dynamic Prior Authorization Specialist with proven expertise at OPTUM in triaging complex medical service requests and ensuring compliance with PBM guidelines. Skilled in ICD-10 coding and critical thinking, I excel in optimizing workflows and enhancing customer satisfaction through effective communication and collaboration.
- Successful pharmacy technician bringing several years of experience in filling prescriptions with expert accuracy, building relationships with customers and promoting teamwork within pharmacy settings. Knowledgeable about regulatory guidelines and policies governing fraud, waste and abuse.
Overview
15
15
years of professional experience
Work History
Prior Authorization Specialist
OPTUM
08.2025 - 10.2025
- Triage prior authorization requests for complex medical services, ensuring 100% compliance with Pharmacy Benefit Management (PBM) guidelines and insurance protocols.
- Coordinate with healthcare providers to Document and gather clinical terminology and essential medical records required for approval of high-needs patient services.
- Apply clinical criteria and ICD-10 coding knowledge to determine the approval or denial of services requiring immediate pre-authorization.
- Manage Patient Profile Management tasks by accurately entering and processing prescriptions into internal Pharmacy Software systems.
Pharmacy Technician
WALGREENS
Florissant
09.2020 - 09.2025
- Processed and filled medication orders with accuracy, ensuring timely delivery for customer needs.
- Assisted pharmacists with daily operations in a retail pharmacy setting.
- Resolved customer inquiries and complaints, delivering effective solutions to enhance satisfaction.
- Answered and managed 60-80 calls daily in a high-volume setting, addressing concerns efficiently.
CSA
Walgreens
Florissant
08.2016 - 09.2020
- Handled cash register operations accurately during peak times.
- Trained new staff on operational procedures and customer interaction protocols.
- Provided detailed information on special pricing and product offerings, enabling customers to make informed purchasing decisions.
- Managed daily retail front operations, enhancing store cleanliness and organization to improve customer experience.
- Organized products on shelves to maintain visual appeal and facilitate customer access.
Cashier
SHOP N SAVE
Florissant
08.2012 - 06.2016
- Handled cash, credit, and debit transactions while ensuring security protocols were followed.
- Greeted customers and provided friendly, excellent customer service.
- Provided customers with information about products and services to support informed purchasing decisions.
- Maintained clean, organized checkout areas to enhance customer satisfaction.
Education
High School Diploma -
HAZELWOOD WEST HIGH
Hazelwood, MO05.2011
Skills
- Prior authorizations
- Claims processing
- ICD-10 CODING
- DOSAGE CALCULATION
- PBM - 3 months experience
- Prescription systems
- HEALTHCARE REGULATIONS
- HIPAA COMPLIANCE
- CRITICAL THINKING
- PROFESSIONAL PHONE SKILLS
- CUSTOMER SERVICE
- TEAM COLLABORATION
Languages
English
Native/ Bilingual
Timeline
Prior Authorization Specialist
OPTUM
08.2025 - 10.2025
Pharmacy Technician
WALGREENS
09.2020 - 09.2025
CSA
Walgreens
08.2016 - 09.2020
Cashier
SHOP N SAVE
08.2012 - 06.2016
High School Diploma -
HAZELWOOD WEST HIGH