Clinical Operations Representative Ii resume example with 18+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Administrative Assistant experienced at registering patients, scheduling appointments and recording and filing patient medical records. Enters orders and information quickly and accurately. Inpatient and outpatient records coding specialist. Enthusiastic Administrative Assistant with excellent people skills and dedicated work ethic. Strong attention to detail and extensive knowledge of medical terminology.Familiar with commercial and private insurance carriers. Seeks a position of increased responsibility and authority.

Skill Highlights
  • Maintains strict confidentiality
  • Knowledge of HMOs, Medicare and Medi-Cal
  • Extensive anatomy/physiology knowledge
  • Medical Manager Software
  • Electronic Medical Record (EMR) software
  • Neurology billing expertise
  • HIPAA compliance
  • Medical billing software
  • Strong planning skills
  • Technical expertise
  • Patient-focused care
  • Strong work ethic
  • Team player with positive attitude
  • Deadline-driven
  • Good written communication
  • Exercises good judgment
Professional Experience
Clinical Operations Representative II, 06/2014 - Current
Paradies Lagardère Travel Retail Palm Springs, CA,

Recorded and filed patient data and medical records.Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.Strictly followed all federal and state guidelines for release of information.Directed patient flow during practice hours, minimizing patient wait time.Acquired insurance authorizations for procedures and tests ordered by the attending physician.Scheduled patient appointments.Completed registration quickly and cordially for all new patients.Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.Confirmed patient information, collected copays and verified insurance.Posted charges, payments and adjustments.Efficiently performed insurance verification and pre-certification and pre-authorization functions. Obtained and validated patient information from various sources and to ensure information entered into the computer management system is accurate. Provided patient services and administrative support in clinical operations. Used MedAptus pro software to accurately capture and also manage physician professional charges. Used MedAptus tech automation to streamline and ease outpatient facility coding and billing. Completed Passport OneSource training, which allows user to verify addresses, insurance eligibility, referrals and precerts, and claim statuses. Used SCI Solutions for gathering and distributing information necessary for scheduling, registration, clinical work flow, and billing and revenue management.

Patient Access Representative II/Registration & Admissions, 02/2013 - 06/2014
Credit Union Of Denver Lakewood, CO,

Worked in the Emergency Room in a fast paced environment.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

Directed patient flow during practice hours, minimizing patient wait time.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.Arranged and assisted with hospital admissions.Completed registration quickly and cordially for all new patients. Confirmed patient information, collected copays and verified insurance. Provided patient services and administrative support in clinical operations. Interacts with parents, patients, physicians, and other staff under moderate supervision in a courteous manner. Performs the registration process for all inpatients and outpatients in the Emergency Room and Admissions Department. Make copies of identification and insurance cards at time of registration. Communicated bed assignments to sending and receiving units throughout the hospital by answering various phone calls in Admissions. Obtained required forms and signatures and completes all managed care notification requirements. Contacted various payers to obtain co-payment and deductible information through a real time eligibility process. Discussed co-payment, deposits or payment in full requirements with parents when patient is in Emergency Department or if the patient is being admitted to the hospital. Identified opportunities to improve clinical and administrative processes for a better flow in the Emergency Department

Child and Youth Program Assistant IV, 05/2010 - 07/2012
Nouria Energy Boylston, MA,

Organized activities that developed children's physical, emotional and social growth.Redirected children to encourage safe, positive behaviors.Helped facilitate indoor and outdoor play, parent-teacher conferences and keeping the classroom clean.Created daily lesson plans for activities.Physically and verbally interacted with children throughout the day.Made nutritious snacks and meals for children.Collaborated daily with classroom teachers to keep activities running smoothly.Established and maintained a safe play environment for the children.Monitored children's play activities to verify safety and wellness.Taught children personal care behaviors, including toilet training and feeding.Stayed current on all toy and child-related recalls and safety warnings.Continually encouraged children to be understanding and patient with others.Monitored educational progress by keeping detailed individual charts and files.Openly exchanged ideas and materials with coworkers. Assisted in developing curriculum and implementing the same in accordance to the children's specific need. Maintained control of and accounts for the whereabouts and safety of children ages from 6 weeks to 5 years old. Observed children for signs that may indicate illness, abuse, or neglect and reports as directed. Attended staff meetings and training programs. Improved language development, social skills, and understanding of scientific and mathematical concepts by using children's play, such as story telling and games.

Project Volunteer Coordinator, 2010 - 07/2012
Albert Einstein College Of Medicine Bronx, NY,

Managed the receptionist area, including greeting visitors and responding to telephone and in-person requests for information.Greeted visitors and explained U.S. Army Corps of Engineers water resource development activities and missions; also how the Corps supports the Department of Defense activities in the Pacific and the nation. Designed electronic file systems and maintained electronic and paper files.Maintained the front desk and reception area in a neat and organized fashion.Planned meetings and prepared conference rooms.Made copies, sent faxes and handled all incoming and outgoing correspondence. Responsible for the local administration of the volunteer program. Served as the Coordinator for the wounded warriors that transitioned through the Visitor Center in order to obtain experience as a Visitor Aid/Receptionist. Managed the program according to policy to ensure that it met the need of the Corps and the volunteers. Assisted with the evaluation and recommendations of new displays for the Visitor Center which include researching ideas for feasibility. Coordinated and scheduled all training and work schedule for new volunteers to operate the Regional Visitor Center. Assisted the Senior Park Ranger with planning, organizing, and administering the daily operations of the Regional Visitor Center, including identifying staffing requirements, developing staffing patterns, evaluation the performance of lower graded employees and addressing employee problems and concerns. Developed a quick reference guide to assist them in answering frequently asked questions form visitors in the center. Conducted guided tours, and ensured accurate visitor counts were recorded and submitted monthly reports to the supervisor. Confirmed all volunteers service agreements and parental consent forms were completed for volunteers or group of volunteers during special events to include: Earth Day, World Water Monitoring Day, Keiki Water Festival, National Public Lands Day and World Wetland Day. Coordinated, scheduled and conducted programs on site to hundreds of school age students, clubs, and civic organizations. Acted quickly on submitting work orders for repairs of existing equipment in the Regional Visitor Center. Coordinated leave schedule with supervisor to make sure the Visitor Center is open during normal duty hours.

Sales Associate/Cashier, 01/2010 - 05/2010
Army And Air Force Exchange Services City, STATE,

Received and processed cash and credit payments for in-store purchases.Placed special merchandise orders for customers.Opened and closed the store, including counting cash, opening and closing cash registers. Shared product knowledge with customers while making personal recommendations.Demonstrated that customers come first by serving them with a sense of urgency.Worked as a team member to provide the highest level of service to customers.Maintained friendly and professional customer interactions.Exchanged returned merchandise for customers quickly and efficiently.Served as liaison between customers and store personnel.Informed customers about sales and promotions in a friendly and engaging manner.Offered Military Star credit card applications upon checkout. Answered customers’ questions and addressed problems and complaints. Processed all sales transactions accurately and in a timely fashion.

Teller, 08/2006 - 09/2008
Bank Of America City, STATE,

Managed opening and closing times for the main branch.Processed sales referrals and promoted bank services and products. Established new customer accounts including checking, savings, lines of credit and loans.Balanced daily cash deposits and bank vault inventory with a zero error rate.Assembled in-store marketing displays.Processed cash withdrawals.Adhered to Bank of America security and audit procedures. Researched and resolved customer issues on personal savings, checking and lines of credit accounts.Examined checks for identification and endorsement.Entered member transaction data into the online banking software.Processed treasury, tax and loan payments.Reported daily averages and shortages to the operations department. Maintained confidentiality of bank records and client information.Received regional branch recognition award for outstanding customer service.Delivered prompt, accurate and excellent customer service.Directed specific questions to appropriate branch personnel. Met referral goals by at least 90 percent. Contributed to a positive team environment through 360 degree coaching.

Sales Associates, 01/2005 - 08/2006
Copy Club Parcel Plus City, STATE,

Assisted businesses with a wide range of products and services. Other services: printing and copying, posters and banners wide-format printing and mounting, business cards, mailing, a full range of packaging and delivery services. Account management throughout the process, coordinated a variety of administrative projects within the office to include the development, analysis and modification of internal administrative policies, procedures and management processes of the office. Searching for and assembling information from files and documents for management and office staff. Assisted potential customers by being knowledgeable on each product. Ensured the storefront looked presentable, compelling, and aesthetically pleasing to customers. Greeted customers and assisted with purchases for the largest arts and crafts specialty retailer in the United States. Reviewed all correspondence written for management staff including letters, memorandum, reports, charts, briefing materials, and talking points. Generated sales through optimized visual merchandising, inventory availability, and personalized assistance. Maintained inventory control and merchandise stocking. Monitored records and tracking utilization of various office supplies and equipment. Assisted customers with their purchases and special orders.

Senior Administrative Assistant, 03/2000 - 07/2004
C.W. Phelps Funeral Home City, STATE,

Designed electronic file systems and maintained electronic and paper files.Maintained the front desk and reception area in a neat and organized fashion.Served as central point of contact for all outside vendors needing to gain access to the building.Planned meetings and prepared conference rooms.Dispersed incoming mail to correct recipients throughout the office.Made copies, sent faxes and handled all incoming and outgoing correspondence.Organized files, developed spreadsheets, faxed reports and scanned documents.Managed the day-to-day calendar for the company’s senior director.Properly routed agreements, contracts and invoices through the signature process.Received and distributed faxes and mail in a timely manner. Acted as a liaison between the owner and potential client. Created sales portfolios that were customized for each prospective client.

Education and Training
Bachelor of Science: Biology, Expected in 2008
Clark Atlanta University - Atlanta, GA
: Nursing, Expected in
Howard University - Washington, DC
: Pre-nursing, Expected in
Hawaii Pacific University - Honolulu, HI

Service of Excellence Award 2011-2012. The National Society of Collegiate Scholars 2013.


Professional and friendly. Careful and active listener. Multi-tasking. Proficient in Microsoft Office. Type 50 WPM.

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Resume Overview

School Attended

  • Clark Atlanta University
  • Howard University
  • Hawaii Pacific University

Job Titles Held:

  • Clinical Operations Representative II
  • Patient Access Representative II/Registration & Admissions
  • Child and Youth Program Assistant IV
  • Project Volunteer Coordinator
  • Sales Associate/Cashier
  • Teller
  • Sales Associates
  • Senior Administrative Assistant


  • Bachelor of Science

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