Montgomery Street, San Francisco, CA94105(555) 432-1000, resumesample@example.com
Professional Summary
Experienced Healthcare Administrator with a educational background in Healthcare Management with strong clinical and people skills. Detail-oriented with extensive experience performing medical clerical duties and patient screenings in a busy healthcare setting.Patient-focused with over 9 years experience working in a busy medical office working with diverse populations. Very Responsible and resourceful with excellent communication skills demonstrated by 9 years of experience in healthcare.
Education and Training
Expected in 2016Master of Science | Public HealthArgosy University, , GeorgiaGPA: GPA: 3.7 Coursework in Health Services Coursework in Human Resource, Community and Public Health GPA: 3.7
Expected in 2012Bachelor of Science | Healthcare ManagementClayton State University, , GeorgiaGPA: GPA: 3.3 GPA: 3.3 Coursework in Healthcare Policy, Services, Health and Human Services and Human Resources and Management
Expected in 2013 | PhlebotomyNational Healthcare Association, , GeorgiaGPA: Professional Accreditation and trained Phlebotomist
Expected in May 2006Certified Nursing Assistant----- | , , GPA:
Skill Highlights
Conflict resolution
Personal and professional integrity
Relationship and team building
Staffing management ability
Proven patience and self-discipline
Government relations knowledge
Financial aptitude
In-depth claims knowledge
Claims analysis and review specialist
Critical thinking proficiency
Strong work ethic
Healthcare billing proficiency
Strong medical ethic
Problem resolution ability
Extensive medical terminology knowledge
Complex problem solving skills
Microsoft Office Suite
Budgeting and financial management
Strong decision maker
Documentation procedures expert
Calm and level-headed under duress
Medical terminology knowledge
Maintains strict confidentiality
Knowledge of HMOs, Medicare and Medi-Cal
Medical Manager Software
Managed care contract knowledge
Electronic Medical Record (EMR) software
ICD-9 coding
HIPAA compliance
Strong planning skills
Qualified in specimen collection/processing
Training and development
Personnel records maintenance
Regulatory compliance
Exceptional interpersonal skills
Skills
Regulatory compliance, Specimen handling, Staff training/motivation/development, HIPAA compliance, HMO, indemnity, and commercial insurance, Medical and clinical services, Medical terminology, Patient relations, Phlebotomy, Policy development and implementation, Private practice experience, Quality assurance standards, Patient-focused care Excellent interpersonal skills Time management Detail-oriented Effectively interacts with patients and families. Charting and record keeping
Professional Experience
07/2014 to CurrentLab Administration Compliance SpeciliastUsmm | South Bend, IN,
Supervised and evaluated the activities of medical, nursing, technical, clerical, service, maintenance and other personnel.
Kept abreast of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes and financing options.
Carefully selected, developed and retained qualified staff, as well as trained 6 new staff annually.
Created annual goals, objectives and budget and made recommendations to reduce costs.
Administered, directed and coordinated the activities of the agency.
Served as liaison between management, clinical staff and the community.
Directed the installation of improved work methods and procedures to achieve agency objectives.
Ensured the accuracy of public information and materials.
Actively maintained up-to-date knowledge of applicable state and Federal laws and regulations.
Provided thorough supervision for day-to-day operations of facility in accordance with set policies and guidelines.
Regularly evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed.
Diligently monitored the QA (Quality Assurance) program to improve performance and maintain high standards of care.
Organized and led weekly personnel meetings with 10 team members.
Observed strict confidentiality and safeguarded all patient-related information.
Provided administrative and laboratory leadership to the staff and helped improve annual error rate from 60 percent to 20 percent.
Plans, organizes, directs and coordinates a statewide clinical laboratory service.
Develops and establishes laboratory goals, policies, programs and plans.
Appraises needs for laboratory services; develops new, additional or different laboratory service programs.
Responsible for validating, entering, and finalizing sales agreements to ensure external clients are billed correctly and accurately.
Supervises the preparation and maintenance of laboratory records and reports; summarizes laboratory activities, accomplishments and needs.
Develops and implements policies, procedures and performance standards designed to ensure efficient laboratory operation.
Interprets or verifies difficult or unusual analyses; plans and supervises the performance of special tests and projects.
Consults with physicians, hospital personnel and independent and hospital laboratory personnel regarding common laboratory problems.
Medical / financial data is processed and analyzed accurately and in a timely manner.
07/2012 to 01/2014DENIAL MANAGEMENT SPECIALIST Good Samaritan Society | West Fargo, ND,
Resolves billing issues by answering questions to determine and recommend how outstanding accounts should be processed and provides follow up when necessary.
Thoroughly investigated past due invoices and minimized number of unpaid accounts.
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Acquired insurance authorizations for procedures and tests ordered by the attending physician.
Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
Researches and reviews billing systems to make sure patient information is accurate and up to date; Communicates with internal personnel, third party payers, employer groups and attorneys to obtain correct patient account information.
Identifies and reports trends in carrier payments and denials, which includes maintaining a database of insurance carrier requirements.
Maintains knowledge of current government and carrier regulations relevant to the industry.
Accurately and efficiently processes billing paperwork, prepares reports and sends invoices.
Must maintain patient confidentiality and follow guidelines as outlined by HIPAA.
2011 to 07/2012FRONT AND BACK OFFICE SPECIALISTApex Systems | Mesa, AZ,
Provided support services for patients by taking vitals, phlebotomy, and taking chief complaints.
Utilized Practice Fusion for medical billing and coding purposes.
Scheduled and confirmed doctor appointments and collected patient information and payments.
Answered phones and registered patients.
Triaged to partner facilities utilizing Practice Fusion.
04/2007 to 2009CERTIFIED NURSING ASSISTANT SHANNON PRIVATE HOME CARE | City, STATE,
Provided nursing care in accordance with resident care policies and procedures.
Ensured that the safety and well-being of the residents was maintained.
Measured and recorded residents' fluid intake and output.
Provided medication reminders to residents.
Provided patient transportation to doctor appointments.
to Lab AnalystCastle Medical LLC | City, STATE,
Appropriate
codes are used and complete information is input.
Attention to
detail of specimen information to assure all information is entered
accurately.
Clarified and
documented all acceptable specimens on lab requisition form.
Ensures
appropriate storage, racking, and tracking of specimens; retrieves
specimens in a timely manner for add-on testing.
Follows
established laboratory safety practices.
Verifies
and labels specimens and aliquots as required according to department
procedures.
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