Charles Ragsdale
@charlesragsdale
I am a seasoned pharmacy technician and healthcare appeals specialist improving compliance and patient access.
What I'm looking for
I am a certified pharmacy technician and Medicaid appeals specialist with experience across retail, hospital and payer settings. I focus on ensuring regulatory compliance and improving member access to needed medications and services.
At payer organizations I researched and investigated appeals and grievances, prepared written case summaries for adverse determinations and State Fair Hearings, and facilitated appeal committee meetings. I maintained compliance with state and federal requirements while coordinating with providers and independent review organizations.
In operational roles I supervised pharmacy technicians, trained staff on aseptic technique and IV compounding in USP 797 cleanrooms, and monitored controlled substance and inventory systems such as Pyxis and Baxa. I developed and revised SOPs, performed root cause analysis, and led quality review and audit preparation activities.
I hold current Certified Pharmacy Technician credentials, serve as a notary and notary loan signing agent, and am enrolled in a Healthcare Management degree program. I aim to apply my blend of clinical, regulatory and training experience to roles that strengthen compliance and improve patient outcomes.
Experience
Work history, roles, and key accomplishments
Owner, Notary Public
Jared-Mart Notary Services, LLC
Dec 2024 - Present (8 months)
Founded and operate a notary and fingerprinting services business, providing loan signing, apostille, and certified fingerprinting services since 12/2024.
Appeals & Grievances Coordinator
AmeriHealth Caritas
Mar 2023 - Dec 2024 (1 year 9 months)
Researched and resolved Medicaid appeals and grievances, prepared written case summaries for State Fair Hearings, and facilitated appeal meetings to maintain state and federal compliance.
Sr. Customer Service Associate, CPhT
Cigna HealthSpring/Express Scripts
Oct 2014 - Jun 2021 (6 years 8 months)
Processed Medicare coverage determinations and prior authorizations, managed appeals and medical director reviews, and led root-cause quality reviews to ensure Medicare Part D compliance.
Certified Pharmacy Technician/Analyst
CareFusion
May 2014 - Jun 2014 (1 month)
Configured device software parameters and network settings on PC units, trained new hires on verification procedures, and improved workflow through delegated task monitoring.
Pharmacy Technician Supervisor
Summit Medical Center
Mar 2013 - Nov 2013 (8 months)
Supervised technicians compounding IVs and cytotoxic preparations under USP 797, trained staff in aseptic technique, and enforced quality assurance protocols to reduce errors.
Pharmacy Technician Supervisor
IV Solutions
Sep 2009 - Nov 2012 (3 years 2 months)
Managed inventory control and accounts payable, optimized technician workflows, and maintained QA and financial records to improve operational efficiency and reduce costs.
Pharmacy Technician Specialist
Vanderbilt University Medical Center
Oct 2007 - Jul 2009 (1 year 9 months)
Prepared and delivered medications including narcotics, compounded TPNs and cytotoxic drugs, and trained technicians and students in aseptic technique and performance monitoring.
Education
Degrees, certifications, and relevant coursework
Capella University
Healthcare Management
2023 -
Enrolled in Capella University's Healthcare Management program since October 2023. Degree in progress.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
Skills
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