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infusion precertification coordinator resume example with 16+ years of experience

JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary

Hardworking Account Manager gifted at lead generation and efficiently resolving customer issues. Engaging and personable with the ability to increase business opportunities through outstanding client presentations, effective communication skills and a dedication to customer service. Detailed professional possessing creative mindset and talkative personality. Offering 22-year background in account management. Experience in delivering client-focused solutions and managing multiple projects simultaneously. Excellent critical thinking, problem-solving and communication skills.

Detailed professional effective in turning problematic customer accounts into ongoing, lucrative contracts. Looking for an Account Manager position where hard work and dedication will be highly valued.

Skills
  • Goal-oriented
  • Account management
  • Strategic planning
  • Checking quotes
  • Staff management
  • Vendor relations
  • Business development
  • Sales force training
  • Team leadership
  • Ability To Prioritize
  • Insurance Eligibility
  • Written And Verbal Communication
  • Company Guidelines
  • Insurance Policy Coverage Knowledge
  • Health Insurance Verification
  • Benefit Coverage
  • Retro-Authorizations
  • Multi-Tasking Skills
  • Managed Care
Work History
09/2020 to Current Infusion Precertification Coordinator Kemps | Fargo, ND,
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Created and maintained spreadsheets detailing all medical procedures, including applicable denials and approvals.
  • Fielded telephone inquiries on authorization details from plan members and medical staff.
  • Supported providers in outpatient medical office through coordinating all administrative operations.
  • Completed administrative patient intakes with case histories, insurance information and mandated forms.
  • Input all patient data regarding claims and prior authorizations into system accurately.
  • Used CareCloud and WeInfuse to maintain over 300 candidate files and file notes.
02/2017 to Current Independent Sales Agent Westchester Medical Center | Stony Point, NY,
  • Brought in new accounts through successful networking strategies and promotional approaches
  • Boosted sales numbers with proactive account servicing and diligent relationship-building
  • Trained New Agents on sales and account management practices to reduce process lags and enhance performance, efficiency and profitability
  • Landed 300 new customer accounts through effective customer service and powerful cold-calling scripts
  • Cross-sold additional products and services to purchasing customers
  • Educated customers on suitable products and services depending on age, needs and inventories to increase sales by 30%
  • Coordinated with General Manager and Administrator to plan, build, carry out and measure campaigns
  • Managed and maintained client book of 600 accounts and weekly sales records
09/2014 to 04/2015 Customer Service Specialist RMB, INC | City, STATE,
  • Maintained confidentiality of patient finances, records and health statuses
  • Followed up on denials, late payments, extensions and other special circumstances
  • Researched and resolved routine and complex issues
  • Posted payments to accounts and maintained records
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt
  • Verified client information by analyzing existing evidence on file
  • Adhered to all established company policies and departmental procedures. Remained current on Federal and State regulations and statues that influence collections of receivables
  • Performed other duties as assigned by managing supervisor
  • Resolved average of 150 inquiries per week to consistently meet performance benchmarks, including speed, accuracy and volume
10/2000 to 08/2012 Practice Administrator Georgia Infectious Diseases, PC | City, STATE,
  • Managed all aspects of multi-physician medical practice and office logistics from physician-employee-patient scheduling, network connectivity (e.g., satellite office, laboratory) billing, insurance, physician contracting with insurance companies-independent physician associations-hospitals, purchasing, marketing, payroll, reconciling practice financials for accountants and financial advisors
  • Acted as liaison between physician, employee, and patient in clinical setting and business setting
  • Responsible for renewing and maintaining records for physician's federal and state licensure's. (e.g., DEA, Georgia controlled substance, state medical license, malpractice insurance, long term/disability insurance)
  • Scheduled Medical Reviews maintained credential's for physicians as well as arranged travel accommodations for conferences
  • Developed and managed practice's in house billing and collections department
  • Implemented and ensured state and corporate regulatory policies and procedures into daily office practices, informing and training staff members. (e.g., HIPAA, RED FLAG RULE, OSHA, CLIA)
  • Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, OBRA, payroll and benefits administration and general liability
  • Optimized patient/physician/employee scheduling and time to best increase profits and accounts receivables. Recognized value of utilizing specialized treatments to increase revenue and high standard of patient care
  • Managed Daily Close to include overseeing patient demographics, charges, insurance payments, and patient payments
  • Balanced daily close by generating end of day reports against employee batches
  • Supervised billing department, front office and medical staff of 15 employees
  • Conducted employee staff meetings and performance evaluations in effort to increase productivity
  • Processed invoices, cut checks, reviewed statements for corporate accounts payable. Reconciled General Ledger accounts
  • Managed employee healthcare benefits and 401K with accountants and financial advisors
  • Implemented connectivity payroll system to track employee work hours, trends and scheduling
  • Managed transition of EMR (Greenway-Prime Suite) System
Education
Expected in 1994 Associate of Science | Health Administration Darton State College, Albany, GA GPA:
Certifications

Licensed Insurance Agent- GA

Life & Health

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Resume Overview

School Attended

  • Darton State College

Job Titles Held:

  • Infusion Precertification Coordinator
  • Independent Sales Agent
  • Customer Service Specialist
  • Practice Administrator

Degrees

  • Associate of Science

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