Tionna Richardson
Raleigh,NC
Summary
Dynamic customer care professional with extensive experience at CVScaremark, excelling in service delivery and training development. Proven ability to enhance client satisfaction through effective communication and active listening. Skilled in medical billing and coding, with a strong focus on achieving compliance and operational efficiency. Committed to fostering a culture of excellence.
Overview
6
6
years of professional experience
Work History
Customer Care
CVScaremark
06.2022 - 04.2025
- Collaborated with senior management to establish key performance objectives for the Customer Care Team, aligning individual goals with overall business strategies.
- Championed company policies and values within the Customer Care Team, instilling a culture of excellence in service delivery across all interactions with customers.
- Provided exceptional customer care through active listening skills and addressing concerns promptly.
- Contributed to the development of company-wide training materials aimed at elevating standards for customer care across all departments.
Claims Specialist
CVScaremark
06.2022 - 04.2025
- Processed and adjudicated claims efficiently, ensuring compliance with company policies and regulations.
- Resolved customer inquiries and disputes, enhancing client satisfaction through effective communication.
- Collaborated with healthcare providers to verify claim details, improving accuracy of submitted information.
- Reviewed documentation for completeness, identifying discrepancies to expedite claims processing.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
Prior Authorization Specialist
CVScaremark
06.2022 - 04.2025
- Processed prior authorization requests with accuracy and attention to detail.
- Communicated effectively with healthcare providers to obtain necessary information for approvals.
- Reviewed clinical documentation to ensure compliance with established guidelines and protocols.
- Utilized electronic health record systems to track and manage authorization workflows efficiently.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
Provider Data Specialist
UnitedHealthcare
01.2019 - 06.2022
- Analyzed provider data discrepancies, ensuring accuracy and compliance with regulatory standards.
- Executed routine audits of provider information to maintain data integrity across systems.
- Collaborated with cross-functional teams to streamline data entry processes, enhancing operational efficiency.
- Supported onboarding of new providers by verifying credentials and updating databases promptly.
Education
Southeastern High School
02.2022
Skills
- Customer care experience
- Customer care standards
- Customer care
- Career development counselor
- Epic 5 years
- Medical billing and coding
Timeline
Customer Care
CVScaremark
06.2022 - 04.2025
Claims Specialist
CVScaremark
06.2022 - 04.2025
Prior Authorization Specialist
CVScaremark
06.2022 - 04.2025
Provider Data Specialist
UnitedHealthcare
01.2019 - 06.2022
Southeastern High School