Summary
Overview
Work History
Skills
Skills
Education
Timeline
Generic

Rhonda Richardson

Clayton,NC

Summary

Highly motivated and detail-oriented Bachelor of Business Administration graduate with a strong foundation in accounting and claims management. Proven ability to analyze complex data, verify documentation, and ensure compliance with regulatory policies. Skilled in evaluating and processing claims efficiently while maintaining a high level of accuracy and customer service. Adept at working in fast-paced environments, leveraging excellent communication, problem-solving, and organizational skills to support decision-making and improve claims approval processes.

Overview

16
16
years of professional experience

Work History

Sourcing Specialist

R&B Services, LLC
10.2015 - 06.2023
  • Monitor supplier performance metrics including lead time, quality, and cost efficiency, and resolve any performance issues
  • Identify, evaluate, and select suppliers based on quality, cost, and reliability
  • Maintain accurate records of sourcing activities, contracts, and supplier information
  • Generate reports on cost savings, supplier performance, and sourcing strategies
  • Managed portfolio of suppliers, ensuring compliance with contractual terms and conditions, as well as quality standards.
  • Developed sourcing strategies to improve procurement processes, supplier relationships and capability development to optimize supply chain.
  • Increased on-time delivery rates by closely monitoring supplier performance and addressing potential issues proactively.

Enrollment Specialist

Elite Professional Management
10.2010 - 12.2014
  • Sourced and screened qualified passive candidates using innovative strategies, including cold calling, social media, and networking tools
  • Collaborated with recruiters and hiring managers to align business objectives with candidate profiles
  • Promoted candidate diversity and recommended potential hires for further evaluation
  • Resolving enrollment problems or discrepancies
  • 'Managed approximately 40 incoming calls, emails and faxes per day from customers.

Claims Processor (Contract)

UnitedHealth Group
08.2013 - 11.2013
  • Processed Commercial, Medicare and Medicaid claims within financial guidelines and ensured compliance with privacy laws
  • Conducted thorough research and analysis of medical billing and coding
  • Develop ability to work effectively with policyholders
  • Request additional information from policyholders, providers and others as necessary to finalize claim
  • Provide customer service to internal and external customers by answering questions both in writing and by phone
  • Escalated claims that did not meet policy requirements for further investigation
  • Process 20 claims on average base
  • Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
  • Negotiated settlements with policyholders, balancing their needs with financial interests of company.

Manufacturing Associate/ Continuous Improvement Trainee

Kellogg Company
01.2008 - 08.2010
  • Instructed associates on safety, food regulations, and company policies to ensure compliance
  • Performed machine setup, adjustments, and quality inspections to maintain product standards
  • Documents plant layouts as it relates to production flow
  • Communicate effectively with department managers and employees on quality, inspection, and deviation reports
  • Recommend adjustments to production process to obtain desired quality
  • Increase effectiveness and efficiency of production processes through identifying opportunities for improvement to each function areas as well as coordination and communication between functional areas
  • Implement inventory management processes through change process that enables maximum operational efficiency
  • Increased procurement efficiency by reducing material waste by 15%, contributing to overall cost savings.
    • Successfully managed $1,000,000 procurement project, ensuring accurate raw material and finished goods specifications, with production on time and within budget.
  • Followed safety protocols and utilized OSHA-approved PPE to foster safe working environment.
  • Organized work to meet demanding production goals.
  • Made sure that products were produced on time and are of good quality.
  • Recorded and tracked daily production data for management reporting.
  • Assisted in conducting market research, providing valuable data for strategy development.
  • Gathered, organized and input information into digital database.
  • Collected, arranged, and input information into database system.

Skills

  • Insurance Claims
  • Claims Processing
  • Billing & Coding
  • Data Entry
  • Microsoft Office

Problem-Solving

  • Regulatory Compliance
  • Contract Negotiation
  • Active Listening
  • Excellent written and verbal communication
  • Problem-solving skills
  • Call center experience

Claims Processing Software

Medical terminology knowledge

Attention to Detail

  • Cost Analysis
  • Organization skills
  • Policy Interpretation
  • Time Management
  • Multitasking
  • Excellent Communication
  • Organizational Skills
  • Decision-Making

Policy Review

  • Customer Service

Skills

Insurance Claims, Medicare/Medicaid, Claims Resolution, Claims Processing, Billing & Coding, Compliance, Financial Analysis, Medical terminology, Data Entry, Reporting Systems, Microsoft Office (Excel, Outlook), Client Services, Customer Interaction, Negotiation, Problem-Solving, Quality, Privacy Laws, Regulatory Compliance, Safety Standards, Active Listening, Excellent written and verbal communication, Team Leadership

Education

Bachelor of Business Administration - Minor in Accounting

Strayer University
09.2024

Timeline

Sourcing Specialist

R&B Services, LLC
10.2015 - 06.2023

Claims Processor (Contract)

UnitedHealth Group
08.2013 - 11.2013

Enrollment Specialist

Elite Professional Management
10.2010 - 12.2014

Manufacturing Associate/ Continuous Improvement Trainee

Kellogg Company
01.2008 - 08.2010

Bachelor of Business Administration - Minor in Accounting

Strayer University
Rhonda Richardson