Nicole Richardson

Certified Pharmacy Technician (CPhT) with 10+ years of healthcare and pharmacy experience, including 5+ years in prior authorization, medical claims processing, insurance verification, and healthcare compliance. Experienced in Medicare, Medicaid, managed care operations, ICD-10, CPT coding, claims adjudication, appeals, denials, and utilization review.

Pharmacy Technician at AMN Healthcare (2026-01 – Present)

• Supported pharmacy operations in high-volume healthcare settings

Prior Authorization Specialist at Molina Healthcare (2021-01 – 2026-12)

• Processed and reviewed prior authorization requests for Medicare and Medicaid members
• Applied ICD-10 and CPT coding knowledge for coverage determinations
• Resolved billing discrepancies, claims issues, and denials
• Collaborated with providers, pharmacies, and insurance teams

Prior Authorization Specialist at OptumRx (2019-01 – 2021-12)

• Reviewed and processed medication authorization requests

Certified Pharmacy Technician at CVS / Kroger / Walgreens (2008-01 – 2018-12)

• Prescription processing, billing, inventory, workflow, HIPAA training

Associate Degree in Health Science