Health Information Specialist Resume Example

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Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.

  • HRIS training
  • Public health expert
  • Insurance expert
  • Training and mentoring
  • Office administration
  • Account management
  • Medical terminology
Work History
Health Information Specialist, 10/2020 to Current
Bradford Health Services, Inc. Manchester, TN,
  • Updated organizational systems and subsystems to improve and streamline data collection.
  • Created various Excel documents to assist with pulling metrics data and presenting information to stakeholders for concise explanations of best placement for needed resources.
  • Monitored and tracked inventory, assigned work tasks and adjusted assignments based on priorities.
  • Developed appropriate and accurate written and oral responses to communicate scientific and health information to public.
  • Evaluated current processes to develop improvement plans.
  • Helped leaders understand how to effectively manage Tiberius, Concur and our Micro-planning tool.
  • Restructured procedures through coordination of Concur to create and execute projects.
  • Coached business leaders on KPI Metrics, Inventory and Administration.
  • Collected, organized and modeled data using Concur .
  • Conducted thorough reviews of operations to devise and deploy improvement strategies.
  • Compiled research data and gave professional presentations highlighting finds and recommended optimizations.
  • Ran statistical analyses within software to process large datasets.
  • Applied loss functions and variance explanation techniques to compare performance metrics.
  • Managed and monitored all installed systems for highest level of availability.
  • Provided 2nd and 3rd level technical support and troubleshooting to internal and external clients.
  • Monitored and tested application performance to identify potential bottlenecks, develop solutions, and collaborate with developers on solution implementation.
  • Used ticketing systems to manage and process support actions and requests.
  • Activated accounts for clients interested in new services.
  • Provided Tier 1 IT support to non-technical internal users through desk side support services.
Advocacy Administration, 09/2019 to Current
Conduent Incorporated Tulsa, OK,
  • Worked with supervisors and management to maintain status reports and update information for client projects.
  • Composed internal and external correspondence for senior management and reviewed all documentation to eliminate errors.
  • Offered office-wide software support and training, troubleshooting issues and optimizing usage.
  • Consulted with manager on departmental policies and projects.
  • Recorded expenses and maintained accounting records.
  • Interacted with vendors, contractors and professional services personnel to receive orders, direct activities and communicate instructions.
  • Generated reports and typed letters in Word and prepared PowerPoint presentations.
  • Coached new employees on administrative procedures, company policies and performance standards.
  • Sorted and distributed office mail and recorded incoming shipments for corporate records.
  • Scheduled office meetings and client appointments for staff teams.
  • Maintained staff directory and company policy handbook for human resources department.
  • Created PowerPoint presentations for business development purposes.
  • Arranged rapid office equipment repair and maintenance with vendors.
  • Updated organizational systems and subsystems to improve and streamline data collection.
  • Created various Excel documents to assist with pulling metrics data and presenting information to stakeholders for concise explanations of best placement for needed resources.
  • Reviewed existing policies and procedures to make recommendations for enhancing work productivity, recruitment, hiring processes and talent management.
  • Reviewed and screened applicant resumes to identify qualified candidates.
  • Planned and managed recruitment activities for new hires using strategic personnel, staffing and position management practices.
  • Oversaw and managed hiring process and assisted human resources.
  • Served as subject matter expert on Peoplesoft for both clients and internal team members.
Claims Processing Specialist, 10/2016 to 09/2019
Onemain (Formerly Springleaf & Onemain Financials). Melrose Park, PA,
  • Managed large volume of medical claims on daily basis.
  • Paid or denied medical claims based upon established claims processing criteria.
  • Reviewed provider coding information to report services and verify correctness.
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
  • Collaborated with claims department and industry anti-fraud organizations to resolve claims.
  • Tracked all pending authorizations to resolve discrepancies and avoid revenue loss.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Checked documentation for accuracy and validity on updated systems.
  • Researched and resolved issues regarding integrity of data flow into databases.
Customer Care Advocate, 04/2011 to 10/2016
Highmark Blue Cross Blue Shield City, STATE,
  • Maintained accurate and current customer account data with manual forms processing and digital information updates.
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
  • Eliminated inefficiencies by educating and training new employees on best practices and customer care procedures.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Logged call information and solutions provided into internal database.
  • Utilized customized patient teaching tools to support patients.
  • Surpassed performance goals by approaching interactions with resourcefulness, organization and customer-centric solutions.
  • Processed medical records requests from outside providers according to facility, state and federal law.
  • Uploaded physician progress notes, history and physicals into electronic medical records.
Bachelor of Science: Human Resources Management, Expected in 08/2023
University of Maryland - University College - Hyattsville, MD
Certificate : Human Resources Management, Expected in 08/2021
University of Maryland - University College - Hyattsville, MD

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Resume Overview

School Attended
  • University of Maryland - University College
  • University of Maryland - University College
Job Titles Held:
  • Health Information Specialist
  • Advocacy Administration
  • Claims Processing Specialist
  • Customer Care Advocate
  • Bachelor of Science
  • Certificate