Nada Weatherford
Chadbourn,NC
Summary
Patient-focused pharmacy professional with 18 years of experience in high-volume retail settings. Expertise in prescription preparation, insurance claim resolution, inventory control, and patient education. Known for exceptional accuracy, excellent communication, and mentoring junior technicians. Dedicated to providing safe, timely, and compassionate care in compliance with all regulatory standards.
Experienced with navigating healthcare insurance systems to secure treatment approvals. Utilizes keen attention to detail and extensive knowledge of medical coding to streamline processes. Strong understanding of insurance guidelines and patient advocacy to ensure optimal outcomes.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Prior Authorization Administrator
Shields Health Solutions
Stoughton, MA
09.2025 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Maintained organized records and up-to-date files for all completed and pending authorization requests, ensuring easy access during audits or reviews.
Pharmacy Technician
Guiton's Drug Store
Whiteville, NC
03.2008 - Current
- Prepare and label prescriptions with accuracy, verifying medications and dosages to ensure patient safety.
- Process insurance claims and resolve denials by communicating with providers and payers.
- Educate patients on medication usage, side effects, and interactions.
- Create and update patient profiles, including allergies and demographic data.
- Coordinate prescription transfers and manage prior authorizations, including documentation and appeals.
- Provide exceptional in-person and phone service while maintaining strict confidentiality.
- Support a collaborative team environment and mentor junior staff on procedures and compliance.
- Recognized by management for consistent excellence in customer service and pharmacy operations.
Education
High School Diploma - undefined
West Columbus High School
Cerro Gordo, NC06.1997
Skills
Pharmacy Operations: Prescription Preparation
Labeling
Inventory Management
POS Systems
Insurance & Billing: Claims Processing
Prior Authorizations
Billing Adjustments
Refunds
Patient Care: Customer Service
Patient Education
Confidentiality
Problem Resolution
Compliance & Accuracy: Regulatory Compliance
Data Entry Accuracy
Quality Assurance
Team Support: Collaboration
Leadership
Staff Mentoring
Certification
- Certified Pharmacy Technician (CPhT)
- Southeastern Community College – Whiteville, NC
- Issued April 2022
Timeline
Prior Authorization Administrator
Shields Health Solutions
09.2025 - Current
Pharmacy Technician
Guiton's Drug Store
03.2008 - Current
High School Diploma - undefined
West Columbus High School