Patient Account Manager with Data Governance Experience

DE, WILMINGTON, US, ***** • *****************@*****.*** • 302-***-****

ALTORIE RICHARDSON

Patient Account Manager

PROFESSIONAL SUMMARY

Patient Account Manager with two years of experience adept at navigating complex insurance verification and claims adjudication. Demonstrates exceptional problem-solving skills, ensuring compliance with HIPAA standards while enhancing patient satisfaction through empathetic assistance. Proficient in Microsoft Office Suite and excels in leadership roles, fostering a collaborative team environment to streamline processes and improve service delivery.

EMPLOYMENT HISTORY

MASTER DATA MANAGEMENTJul 2025 - Nov 2025

UPS/RandstadRemote

Data governance and quality oversee the implementation of data governance policies, ensure data integrity and quality, and manage data cleansing initiatives.

Stakeholder collaboration work with stakeholders across various departments to understand business needs, gather requirements, and resolve data-related issues.

Process improvement identify and implement opportunities for process improvements related to master data management and data quality.

Implemented streamlined data entry processes, significantly reducing errors and accelerating data availability for decision-making.

Conducted thorough data audits to identify inconsistencies, leading to measurable improvements in data integrity and reporting accuracy.

Partnered with cross-functional teams to enhance data governance protocols, fostering accountability and shared ownership of master data.

PATIENT SERVICE REPNov 2024 - May 2025

IQVIA/Populus GroupRemote

Claim processing receive and process medical claims, ensuring all necessary documentation is present, and determine if a claim should be paid or rejected.

Patient and provider support answer inbound calls and handle customer requests via phone, email, or other methods.

Benefit investigation contact insurance companies to verify benefits and check eligibility for coverage.

Program enrollment assist patients with enrolling in manufacturer and non-profit copay assistance programs.

Prior authorization and appeals provide support for the prior authorization and appeals process.

Data entry accurately document all information obtained during calls and other interactions.

Quality and compliance adhere to program-specific standards, quality guidelines, and all HIPAA regulations.

Provided empathetic assistance to patients, enhancing their experience and fostering trust in the healthcare process.

INTAKE ADMINISTRATOR Nov 2023 - Oct 2024

Business Interface Wilmington, DE

Coordinates client communications, ensuring accurate data entry and file management.

Facilitates client onboarding, maintaining compliance with state regulations.

Optimizes database management, ensuring seamless access to client records.

Conducts efficient intake sessions, achieving high client satisfaction.

Streamlines referral processing, enhancing program enrollment rates.

PRIOR AUTHORIZATION TECHNICIAN May 2023 - Sep 2023

BCBS/Integrated Resources Remote

Reviewed clinical documentation to verify ABA therapy necessity, ensuring compliance with guidelines.

Prepared and submitted complete authorization requests, minimizing insurance denials.

Facilitated communication between clinical teams and insurance reps, enhancing collaboration.

Researched and appealed denied authorizations, improving approval rates.

Maintained accurate patient records, ensuring regulatory compliance.

EDUCATION

PHARMACY TECHNICIAN

Dawn Career Institute

HIGH SCHOOL DIPLOMA

James H. Groves High School

SKILLS

Microsoft Office Suite, Claims adjudication, Insurance verification, HIPPA compliance, Medicare/Medicaid, Quality assurance, Record keeping, Data input, Time management, Problem solving, Communication, Leadership, Coordination, Case Management, Reception, SAP.

REFERENCES

Latricia Vicks, Business Interface LLC (302-***-****); Greer Hughes, Business Interface LLC (302-***-****); Taylor Dubbs, Business Interface LLC (302-***-****); Cheyenne Murphy, Business Interface LLC (915-***-****).

ADDITIONAL INFORMATION

CERTIFICATIONS

Pharmacy Technician Certification

Certified in Medicare/Medicaid

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