Angi Rodriguez
Gurnee,IL
Summary
Resourceful Resolution Specialist known for high productivity and efficient task completion. Skilled in conflict resolution, customer service strategies, and case management. Excel at communication, problem-solving, and adaptability, ensuring successful resolutions that meet both company and client needs.
Overview
10
10
years of professional experience
Work History
Resolution Specialist II Salesforce Team
CVS Specialty Pharmacy
Springfield, IL
10.2022 - Current
- Attended meetings with leadership in order to review and discuss strategies for improving performance related to case resolution.
- Managed multiple tasks simultaneously while adhering to tight deadlines.
- Built strong relationships with leadership and Account management team by providing support and guidance.
- Interacted with internal departments such as sales, billing, collections, technical support. to ensure complete resolution of customer issues.
- Provided training sessions for new hires on how to effectively resolve customer complaints.
- Collaborated closely with cross-functional teams in order to provide comprehensive resolutions for customers.
- Identified root causes of customer concerns, tracked resolution process steps, and documented all actions taken.
- Researched complex customer service requests involving multiple departments and personnel within the organization.
- Monitored progress on active resolution efforts and maintained accurate records of activities performed related to each case.
- Consulted with direct supervisors on matters related to coaching initiatives.
- Ensured compliance with applicable laws and regulations during the resolution process.
Sr. Assistant Authorization Specialist
Coram CVS Specialty Infusion Services
Mount Prospect, IL
01.2020 - 11.2021
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Provided guidance to providers regarding the prior authorization process.
- Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.
- Maintained accurate records of all authorization activities in the database system.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
Practice Liaison
Shields Health Solutions
Chicago, IL
09.2018 - 01.2020
- Acted as a point of contact for customers, suppliers, partners and other third parties to support the delivery of services.
- Maintained positive working relationship with fellow staff and management.
- Coordinated with internal departments to resolve any patient-related issues or inquiries related to pharmacy services.
- Managed relationships with external vendors such as suppliers, wholesalers, manufacturers.
- Evaluated clinical information provided by providers against specific criteria set forth by health plans.
- Facilitated communication between health plan representatives, providers, and members when needed.
- Submitted prior authorization requests electronically or by phone to payers.
Pharmacy Technician III Team Lead
CVS Caremark
Northbrook, IL
09.2014 - 08.2018
- Subject Matter Expert who assisted in training new employees regarding prior authorization processes.
- Team lead who coordinated assignments among team members.
- Provided guidance to providers regarding the prior authorization process.
- Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Educated healthcare professionals on how to properly submit a request for pre-authorization.
Education
Certified Pharmacy Technician
Illinois Department Of Financial And Professional
Mount Prospect, IL09-2014
Business Administration
DeVry University
OnlineSkills
- Case management
- Salesforce, SPRx, SPARCs, HBS, Peoplesafe, Mattersight, SEVE, etc
- Issue resolution
- Organizational Time Management
- Root cause analysis
- Microsoft Excel, Word, and Outlook
- Process improvement
Accomplishments
- I have received received 11 Heart At Work Recognitions for 2024.
Timeline
Resolution Specialist II Salesforce Team
CVS Specialty Pharmacy
10.2022 - Current
Sr. Assistant Authorization Specialist
Coram CVS Specialty Infusion Services
01.2020 - 11.2021
Practice Liaison
Shields Health Solutions
09.2018 - 01.2020
Pharmacy Technician III Team Lead
CVS Caremark
09.2014 - 08.2018
Certified Pharmacy Technician
Illinois Department Of Financial And Professional
Business Administration
DeVry University
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