Breianna Richardson
Baton Rouge
Summary
Motivated and detail-oriented healthcare professional with over 5 years of experience in medical claims, prior authorization, and pharmacy operations. Skilled in claims evaluation, problem-solving, and customer service, with a solid understanding of medical terminology, HIPAA compliance, and insurance processes. Proven ability to manage high volumes of sensitive tasks with accuracy and professionalism.
Overview
8
8
years of professional experience
Work History
Pharmacy Technician
Walgreens Pharmacy
Baton Rouge, LA
10.2023 - Current
- Assist pharmacists with dispensing, labeling, and packaging medications accurately.
- Maintain inventory, label prescriptions, and ensure pharmacy workflow is organized.
- Handle incoming calls from patients and providers with professionalism and knowledge.
Prior Authorization Representative
Envision Radiology
05.2025 - 09.2025
- Coordinate prior authorization requests for imaging services, ensuring timely and accurate submissions.
- Communicate with providers, insurance companies, and patients to obtain necessary documentation and approvals.
- Verify insurance benefits and clinical criteria for medical necessity.
- Maintain compliance with HIPAA and payer-specific guidelines.
- Utilize healthcare software systems to process, track, and document authorization status efficiently.
- Managed prior authorization processes to ensure timely patient access to imaging services.
- Collaborated with clinical staff to resolve complex authorization issues effectively.
Claims Specialist
Blue Cross Blue Shield
Baton Rouge, LA
05.2019 - 07.2023
- Processed medical claims and verified CPT/ICD codes for accuracy and compliance.
- Provided timely and appropriate claim decisions through strong problem-solving.
- Collaborated with departments and anti-fraud teams to ensure resolution and adherence to policy.
- Maintained knowledge of medical claims, HIPAA, and plan provisions for groups of all sizes.
Pharmacy Technician / Shift Manager
CVS Health
Baton Rouge, LA
11.2017 - 05.2019
- Calculated dosages, filled prescriptions, and resolved billing errors.
- Supported pharmacists in customer counseling and addressed inquiries.
- Managed shift operations and interacted with insurance companies for claims.
Education
High School Diploma - undefined
McKinley Senior High School
Baton Rouge, LASkills
- Medical Terminology
- HIPAA Compliance
- Claims & Prior Authorization
- CPT/ICD Codes
- Time Management
- Case Management
- Customer Service
- Analytical Thinking
- Insurance Verification
- EMR Systems
- Communication (Written & Verbal)
- Team Collaboration
- Problem Solving
Timeline
Prior Authorization Representative
Envision Radiology
05.2025 - 09.2025
Pharmacy Technician
Walgreens Pharmacy
10.2023 - Current
Claims Specialist
Blue Cross Blue Shield
05.2019 - 07.2023
Pharmacy Technician / Shift Manager
CVS Health
11.2017 - 05.2019
High School Diploma - undefined
McKinley Senior High School