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EXAMINER Resume Example

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EXAMINER
Accomplishments
  • Airman Below the Zone Certified On-the-Job Training Instructor Infection Control Monitor EMERGENCY ROOM TECHNICIAN Identify potential health risks and provide preventive counseling and perform paraprofessional portions of preventative health assessments and physical examinations.
  • Monitors and records physiological measurements.
  • Admits, discharges, and transfers patients as directed.
  • Perform portions of medical treatment, diagnostic and therapeutic procedures.
  • Records treatments and procedures rendered and observe effects.
  • Identifies patient problems, and assists in developing and evaluating patient care plan.
  • Prepares and administers medications under nurse or physician supervision.
  • Certified On-the-Job Training Instructor.
Professional Summary

Innovative, customer-oriented healthcare administrator with background in managed and ambulatory care.   Strong background in quality assurance, claims analysis and management principles and practices. Seeking a leadership role within an integrated delivery system with experience in ensuring high standards of culturally competent care for wide variety of patients with diverse needs.

Skills
  • AMELA W. WATERS CLAIMS EXAMINER Visionary ~ Workers Compensation ~ Policy~ Government
  • Motivated professional with 10 years of successful work in federal workers compensation. Ability to handle sensitive, confidential records and information. Demonstrate a history of producing accurate, timely compensation payments, medical authorizations and formal decisions. Possess a strong ability for improving and developing processes that lead to strong client relationships, and consistent customer satisfaction. Collaborative communicator focused on building relationships and promoting collaboration across business lines to drive cohesive, comprehensive business approaches and enhanced profitability. Areas of Expertise include:
  • Government
  • Public Administration
  • Attention to detail
  • Workers compensation
  • Research
  • Customer Service
  • Policy
  • Oral and written communication
  • Complex Decision writing
  • Benefits Delivery
  • Problem Solving
  • Medical Coding
  • Strong presentation skills
  • Planning and development
  • Independent judgment and decision making
  • Culturally competent care
  • Curriculum development
  • Program management
  • Risk assessment skills
  • Claims reports and documentation
  • Reporting requirements
  • Emergency Medical Technician (EMT) certification
  • Clinical instruction
  • Problem resolution capability
  • Policy and program development expertise
  • Promotes positive behavior
Work History
US Department of Labor EXAMINER | Dallas, TX | January 2007 - Current
  • Providing workers' compensation coverage to federal employees for work-related injuries and occupational diseases.
  • Independently manage and adjudicate highly complex disability and death cases which involve injuries or illness such as those where the causes are uncertain or the symptoms are subjective.
  • Analyzes and processes complex or technically difficult workers' compensation claims through investigating and gathering information to determine the exposure on the claim.
  • Manage claims through well-developed action plans to accurately process compensation payments and medical upgrades to injury and disease cases.
  • Utilize factual and medical sufficiency and legal correctness according to Federal Employees Compensation Act to manage case files.
  • Ensures claim files are properly documented and claims coding is correct, utilizing proper ICD-10 coding.
  • Meet department standards for customer service, productivity and quality while maintaining a high level of confidentiality and ethics.
  • Conduct research and investigation to ensure that claims decisions are consistent with current laws and regulations and provide written Formal Notice of Decisions in a timely manner.
  • Determines the extent and the nature of disability, continuing causal relationship for work and take appropriate case management measures.
  • Communicate via written correspondence or telephone with physicians, injured workers, attorneys, legal representatives and Congressional constituents.
  • CONTRIBUTIONS & KEY ACCOMPLISHMENTS: Contributed to the improvement of quality FECA benefits delivery for injured federal workers.
  • Responsible for assessing medical documentation received in order to provide timely delivery of benefits.
  • Developed and maintain strong business relationships with attorneys, congressional constituents, physicians and other government personnel.
  • Complete Senior Claims Examiner Training.
Countrywide Financial/Landsafe POLICY Mortgage and Financial Institution | Richardson, TX | January 2005 - January 2007
  • Issue insured title policies that are free and clear of liens or judgments to real estate attorneys meeting deadlines on behalf of The Secretary of Housing and Urban Development (HUD), Veterans Affairs (VA) and Fannie Mae.
  • Research other information provided through various national and state databases such as Netronline, state tax assessors, county Sheriff's offices, LexisNexis-Banko and Public Access to Court Electronic Records (PACER) to check on any bankruptcy information.
  • Review, update and maintain Default Order Tracking (DOT) work flow system through all stages of the policy order process.
  • CONTRIBUTIONS & KEY ACCOMPLISHMENTS:.
  • Certified On-the-Job Training Instructor, responsible and accountable for accurate training for new hires.
  • Ensure new hires were able to perform job requirements and functions to meet or exceed department goals.
United States Air Force AEROMEDICAL TECHNICIAN | San Antonio, TX | January 2000 - January 2004
  • The world's preeminent force in air, space and cyberspace Assisted and implemented patient care under nursing supervision.
  • Provide comfort, morale, safety and welfare of patients/attendants and personnel during transport to and from aircraft by performing anti-hijacking screening procedures.
  • Served as member of primary emergency medical response for in-flight emergencies and potential mass casualty scenarios during on and off-base incidents.
  • Load and unload patients on litter stretcher.
  • Prepare patients and equipment for flight, load and unload baggage.
  • Document vital signs and patient history on Air Force Forms (AF Form) 3899 and Department of Defense Form (DD Form) 602.
  • Perform anti-hijacking and screening procedures to ensure aircraft and personal security of all patients, passengers and staff.
  • Initiates, tracks and coordinate execution of urgent Critical Care Air Transport, Neonatal Intensive Care and Extra Corporeal Membrane Oxygenation patient moves.
  • Dispatch 911 ambulance calls for Lackland Air Force Base.
Education
MBA HEALTH SERVICES MANAGEMENT WEBSTER UNIVERSITY | 2005
Bachelor of Science Community Health Education MORRIS BROWN COLLEGE ATLANTA, GA | 1999
Skills
Air Force, ambulance, Attention to detail, Benefits, case management, Oral, Critical Care, client, customer satisfaction, Customer Service, databases, Delivery, documentation, Forms, Government, ICD-10, Instructor, legal, Medical Coding, Access, communicator, nursing, patient care, Prepare patients, personnel, policies, Problem Solving, processes, producing, coding, quality, real estate, Research, safety, supervision, tax, telephone, upgrades, vital signs, written, written communication
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Resume Overview

Companies Worked For:

  • US Department of Labor
  • Countrywide Financial/Landsafe POLICY
  • United States Air Force

School Attended

  • WEBSTER UNIVERSITY
  • MORRIS BROWN COLLEGE

Job Titles Held:

  • EXAMINER
  • Mortgage and Financial Institution
  • AEROMEDICAL TECHNICIAN

Degrees

  • MBA HEALTH SERVICES MANAGEMENT
    Bachelor of Science Community Health Education

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