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Department Manager Administrative Authorizations resume example with 15+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary

Highly trained professional with a background in verifying insurance benefits/obtaining medical authorizations and creating appropriate patient documentation. An established Insurance Verification/Authorization Specialist known for handling various office tasks with undeniable ease.

Skills
  • Prior authorization processing
  • Understanding of medical terms
  • Accurate and detailed
  • Knowledgeable of Eclinicalworks or EMR.
  • Microsoft office such as: word, excel.
  • Data entry
  • Works well under pressure
  • Verifying insurance coverage
  • Employee timesheet processing
  • Advanced clerical knowledge
  • Professional phone etiquette
Work History
07/2014 to Current
Department Manager/Administrative/Authorizations Ranken Jordan Pediatric Bridge Hospital Maryland Heights, MO,
  • Implemented process improvement initiatives within the department.
  • Established performance goals for employees and provided feedback on methods for reaching those milestones.
  • Ensured that all employees within the authorization/verification department presented a positive, exemplary image to patients.
  • Adhered to all safety procedures and company standards and policies.
  • Built a talented and valuable team of departmental employees through outstanding mentoring, coaching and teaching skills.
  • Handled all customer relations issues in a gracious manner and in accordance with company policies.
  • Communicated clear expectations and goals to each team member.
  • Worked with the management team to implement the proper division of responsibilities.
  • Coached new employees on administrative procedures, company policies and performance standards.
  • Patient check in/check out
  • Scanned physical files into digital records, assigning faxes,medical records.
  • Maintained a clean reception area, including lounge and associated areas.
  • Answering calls, scheduling appointments.
  • Obtaining medical authorizations. 
  • Coordinating care for patients in a workman's compensation and Auto accident related cases. 
  • Assured the timely verification of insurance benefits prior to patient procedures or appointments.
  • Made contact with insurance carriers to discuss their policies and individual patient benefits.
  • Accurately inputted all patient and insurance information into the company’s computer system using Eclinical.
  • Verified and created claim Numbers by communicating with various insurance companies.
  • Observed strict procedures to protect sensitive patient information, including medical records and payment data.
  • Maintained a strong knowledge of basic medical terminology to better understand services and procedures. 
  • Input all documents into the records management system.
  • Assisted senior administrative professionals with daily work tasks.
10/2013 to 02/2014
Administrative Assistant/Authorizations/Insurance Verifier Your Care Clinic City, STATE,
  • Patient check in/check out.
  • Answering calls, scheduling appointments.
  • Obtaining Medical authorizations.
  • Verifying Insurance and benefits prior to patients appointment.
  • Scanning documents,assigning faxes, medical records. 
  • Maintained a clean reception area, including lounge and associated areas.
  • Greeted incoming patients and pharmaceutical reps in a professional manner and provided friendly, knowledgeable assistance.
  • Called patients to confirm scheduled appointments a day in advance.
  • Helped distribute employee notices and mail around the office.
01/2012 to 10/2013
Administrative Assistant/Phlebotomist DCI Biologicals City, STATE,
  • Answered and managed incoming and outgoing calls while recording accurate messages.
  • Assisted administrative team members with completing daily tasks in order to maintain a smooth workflow.
  • Locating Donor's charts to pursue donation process. 
  • Providing the screening process, which consisted of taking the Donor's vitals, checking the Donor's hematocrit and protein levels  through a centrifuge machine. 
  • Inputting data entry by entering new Donor's information into a system called The PDS III, also checked Donor's background through nddr.org. 
  • Performing vein checks to make assure the Donor is  suitable for the donation. 
  • Calibrating machines such as, refractometer, dina map (vitals machine).
  •  Drawing plasma using a 16 gauge needle. 
  • Properly storing plasma post donation for lab relocation. 
  • Responsible for payouts to the donor after the donation. 
05/2006 to 04/2011
Pharmacy Technician Eckerds Mail In Pharmacy City, STATE,
  • Restocked automated medication dispensing equipment.
  • Prepared bills for insurance companies. 
  • Processed incoming drug orders.
  • Assisted the pharmacist with filling prescriptions for 20 to 50 customers daily. 
  • Resolved non-routine issues like third-party billing, computer system and customer service issues.
  • Communicated instructions to patients or caregivers. 
  • Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
  • Counted, measured, and compounded medications following standard procedures.
  • Prepared intravenous solutions, admixtures, respiratory drugs and other solutions using aseptic techniques.
  • Counted and labeled prescriptions with correct item and quantity. 
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Collected co-payments or full payments from customers.
  • Implemented standard procedures for mixing, packaging and labeling pharmaceuticals to ensure quality, security and proper disposal.
  • Prepacked bulk medicines, filled bottles with prescribed medications and affixed correct labels.
  • Hand counted control medications, measured liquids and reconstituted antibiotics.
Education
Expected in 2017
High School Diploma:
Penn Foster Career School - Scranton, PA
GPA:
Expected in 2020
Associate of Arts: Health Science Major
Saint petersburg college - Seminole, FL
GPA:

Currently enrolled , pursuing a degree in Nursing.

Accomplishments

Graduated in 2012 with a 3.5 GPA from Florida Career College for Patient Care Technician.

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Resume Overview

School Attended

  • Penn Foster Career School
  • Saint petersburg college

Job Titles Held:

  • Department Manager/Administrative/Authorizations
  • Administrative Assistant/Authorizations/Insurance Verifier
  • Administrative Assistant/Phlebotomist
  • Pharmacy Technician

Degrees

  • High School Diploma
  • Associate of Arts

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