Livecareer-Resume
JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (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 2016 Master of Science | Public Health Argosy University, , Georgia GPA: GPA: 3.7
Coursework in Health Services Coursework in Human Resource, Community and Public Health   GPA: 3.7
Expected in 2012 Bachelor of Science | Healthcare Management Clayton State University, , Georgia GPA: GPA: 3.3
GPA: 3.3 Coursework in Healthcare Policy, Services, Health and Human Services and Human Resources and Management 
Expected in 2013 | Phlebotomy National Healthcare Association, , Georgia GPA:
Professional Accreditation and trained Phlebotomist
Expected in May 2006 Certified 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 Current Lab Administration Compliance Speciliast Usmm | 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 01/2014 DENIAL 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 07/2012 FRONT AND BACK OFFICE SPECIALIST Apex 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 2009 CERTIFIED 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 Analyst Castle 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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Resume Overview

School Attended

  • Argosy University
  • Clayton State University
  • National Healthcare Association

Job Titles Held:

  • Lab Administration Compliance Speciliast
  • DENIAL MANAGEMENT SPECIALIST
  • FRONT AND BACK OFFICE SPECIALIST
  • CERTIFIED NURSING ASSISTANT
  • Lab Analyst

Degrees

  • Master of Science
  • Bachelor of Science
  • Certified Nursing Assistant-----

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