Summary
Overview
Work History
Education
Skills
Websites
Certification
Timeline
Generic

Angela Richardson

Atlanta,GA

Summary

Expert in communication and interpersonal relations, dedicated to fostering strong client partnerships and motivating teams to achieve operational goals. Proficient in a wide range of software applications including Microsoft Office, Salesforce, and AWS, ensuring efficient workflow and collaboration. Upholds high professional integrity in managing confidential information and records. Experienced in quality assurance, adept at resolving customer complaints and enhancing business processes through analytical problem-solving skills.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Prior authorization (PA) Specialist-Contract

CVS- Medicare D
10.2024 - 12.2024
  • Work closely with providers to process prior authorization (PA), and drug benefit exception requests on behalf of Aetna as the client and in accordance with Medicare Part D CMS Regulations.
  • Research and conduct outreach via phone to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close cases.
  • Responsible for research and correction of any issues found in the overall process.
  • Phone assistance is required to initiate and/or resolve coverage requests.
  • Escalate issues to the Coverage Determinations and Appeals clinical pharmacists and management team as needed.
  • Maintain compliance at all times with CMS and department standards.
  • Reviewed and processed claims to ensure compliance with regulations.
  • Facilitated communication between pharmacy partners and members regarding prescriptions.
  • Resolved complex issues related to member coverage and eligibility efficiently.
  • Coordinated with other departments to ensure efficient workflow processes.
  • Managed member enrollment processes for Medicare D plans.

Patient Access Specialist

Cencora
Atlanta, GA
10.2022 - 07.2024
  • Improved efficiency by maintaining strict confidentiality and adhering to HIPAA guidelines, resulting in an 80% reduction in data security incidents.
  • Utilize advanced technical skills in document management software, such as Microsoft SharePoint, to effectively maintain and update electronic files, ensuring accuracy and compliance.
  • Facilitated effective patient therapy preparation by collaborating with care providers to relay critical information regarding patient concerns, hesitations, and treatment requirements.
  • Utilized advanced data analysis tools to reduce patient registration errors by 20%, resulting in improved accuracy and efficiency in patient access processes.
  • Completed authorization and referral for medical services.
  • Assisted with scheduling appointments, pre-registration activities, verifying demographics and insurance information.
  • Collaborated with healthcare providers to streamline information exchange.
  • Utilized electronic health record systems to maintain patient information accuracy.
  • Greeted patients and visitors in person or on the telephone; answered inquiries, provided directions and instructions.
  • Verified patient insurance coverage, collected copays and other payments, processed credit card transactions.
  • Successfully communicated payer requirement changes to management, ensuring compliance and timely reimbursement, ultimately enhancing revenue and reducing denials.

Clinical Trials Associate (Part-time Contract)

Solar Biomedical Clinical Research Services
Atlanta, GA
03.2021 - 09.2022
  • Assist Clinical Research Associates (CRAs) with accurately updating and maintaining clinical documents and systems (e.g., Trial Master File (TMF)) that track site compliance and performance within project timelines.
  • Assist the clinical team with the preparation, handling, distribution, filing, and archiving of clinical documentation and reports, according to the scope of work and standard operating procedures.
  • Assist with the periodic review of study files for completeness.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Collaborated closely with team members to achieve project objectives and meet deadlines.
  • Completed day-to-day duties accurately and efficiently.

Senior Sales Consultant

Wayfair
Atlanta, GA
10.2021 - 04.2022
  • Developed tailored solutions for clients to enhance their shopping experience.
  • Trained and mentored junior sales consultants on best practices and techniques.
  • Analyzed customer feedback to improve service strategies and product selection.
  • Implemented sales strategies that aligned with company goals and market demands.
  • Supported leadership with development of marketing and sales plans by providing sales data and sharing customer insights.
  • Create written reports or presentations to make recommendations to senior management.
  • Anticipate and communicate projected risks, and find solutions.
  • Conduct portfolio department reviews, and suggest areas of improvement to maximize.

Mail Handler

USPS
Atlanta, GA
05.2013 - 04.2019
  • Managed the sorting and distribution of over 30,000 pieces of mail daily, ensuring proper routing and delivery, while maintaining a 98% accuracy rate, contributing to enhanced operational efficiency.
  • Coordinated the distribution of mail to multiple carriers and warehouses across the United States, ensuring timely and accurate delivery.
  • Managed accurate tracking and delivery of outgoing military government mail, ensuring 100% on-time delivery.
  • Utilized technical skills in mail handling and tracking software to ensure accurate and timely delivery.
  • Served as Union Steward, negotiating labor agreements on behalf of 150+ members, which resulted in a 20% increase in benefits and a 5% salary raise over a three-year period, while maintaining a 98% membership retention rate.
  • Conducted educational sessions for union members, highlighting the principles of solidarity, justice, and the significance of political and legislative actions.
  • Operated mail processing equipment to ensure timely handling of packages.
  • Assisted in loading and unloading delivery trucks with various mail items.
  • Maintained accurate records of incoming and outgoing shipments daily.
  • Collaborated with team members to streamline sorting and delivery processes.
  • Monitored mail flow to identify and resolve potential delays promptly.

Education

Some College (No Degree) - Mass Communications

Georgia State University
Atlanta, GA

Skills

  • Amazon Workspace (AWS)
  • CenterX
  • Cisco
  • Client relations
  • Clinical Trials Associate
  • Data Entry
  • Deltek
  • Dynamic communication
  • EMR software
  • Excel
  • Fusion
  • Genesys
  • HEDIS
  • ICD-10
  • Insurance billing
  • Interpersonal relation skills
  • Knowledge of HIPAA
  • Leadership
  • Mail Handler
  • Microsoft Office
  • Microsoft Outlook
  • Microsoft Teams
  • Motivating teams
  • Patient Access Specialist
  • Record patient history
  • Sales Consultant
  • Salesforce
  • Slack
  • VPN
  • Zoom
  • Customer service
  • Regulatory compliance
  • Communication skills
  • Workflow automation
  • Coaching and mentoring
  • Customer relations
  • Document management
  • Medical terminology
  • Attention to detail
  • Interpersonal communication
  • Customer relationship management
  • Performance metrics
  • Adaptability
  • Organizational skills
  • Task prioritization
  • Self motivation

Certification

Paralegal, Kennesaw State University

Timeline

Prior authorization (PA) Specialist-Contract

CVS- Medicare D
10.2024 - 12.2024

Patient Access Specialist

Cencora
10.2022 - 07.2024

Senior Sales Consultant

Wayfair
10.2021 - 04.2022

Clinical Trials Associate (Part-time Contract)

Solar Biomedical Clinical Research Services
03.2021 - 09.2022

Mail Handler

USPS
05.2013 - 04.2019

Some College (No Degree) - Mass Communications

Georgia State University

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Angela Richardson