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managed care specialist resume example with 8 years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary
Front office administrative assistant with experience supporting multiple physicians in a busy medical office. Expertise includes verifying insurance coverage, records reviews and schedule maintenance.   Detail-focused administrative assistant skilled at medical billing and coding.  Reliable multi-tasker with Internal medicine and family medicine experience.
Enthusiastic Administrative Assistant with excellent people skills and dedicated work ethic. Strong attention to detail and good Customer service-oriented Administrative Assistant skilled in greeting patients, scheduling appointments and preparing patient charts. knowledge of medical terminology. Well qualified referral specialist focusing on specialty referrals and appointments for patients of all ages. 
 
I have been in a position of a referral specialist for the past year. Processing specialty referral for patients.  Making appointments when needed, obtaining prior authorizations when necessary.  Tacking referrals and procedures in an Excel spreadsheet for the purpose of making sure the referral is completed and the appointment was kept and the consult was received. I have excellent phone etiquette and relationship with other offices that I communicate with for business related  to my employment.  I present myself in a mature professional manor at all times.  My past medical terminology, medical coding, medical records and front office assistant experience give me the skills that you are seeking.

Licenses
Medical Billing and Coding Specialist
Skill Highlights
  • Referral tracking
  • Medical billing
  • Strong work ethics
  • Problem solver
  • Strong medical terminology knowledge
  • Organized
  • Ability to prioritized workload
  • Knowledge of the electronic medical record
Professional Experience
Managed Care Specialist, 10/2015 to Current
Promedica Senior CareCortez, FL,
Maintained patient privacy and confidential patient information. Ensured HIPAA compliance. Strictly followed all federal and state guidelines for release of information. Wrote clear and detailed clinical phone messages for physicians. Acquired insurance authorizations for procedures and tests ordered by the attending physician. Maintained an organized logging system for tracking specialty referrals. Scheduled surgeries and procedures in conjunction with Surgical Coordinator. Scheduled patient appointments.  Monitored shared email in-boxes and ensured inquiries were addressed.  Scheduled radiology exams for patients. Accurately entered procedure codes, diagnosis codes and patient information into billing software. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Received, organized and maintained all coding and reimbursement periodicals and updates. Efficiently performed insurance verification and pre-certification and pre-authorization functions.
Scheduling, 07/2015 to 10/2015
Midland Community Healthcare ServicesMidland, TX,
Strictly followed all federal and state guidelines for release of information. Wrote clear and detailed clinical phone messages for physicians. Directed patient flow during practice hours, minimizing patient wait time. Scheduled patient appointments. Completed registration quickly and cordially for all new patients. Monitored shared email in-boxes and ensured inquiries were addressed. Provided administrative support for several physicians. Performed transcription duties for Behavioral Health specialists.  Transcribed correspondences for two designated providers of this practice. 
Medical Records Clerk, 03/2015 to 07/2015
Community Health Centers Of The Rutland RegionCity, STATE,
Recorded and filed patient data and medical records. Strictly followed all federal and state guidelines for release of information. indexed information into the patients electronic medical record via the system manager. Attached orders to consult notes that were indexed through the system manager to complete the referral process and complete the order for physician review. 
 

Front office Representative / Switchboard Per diem , 04/2013 to 03/2015
Community Health Centers Of The Rutland RegionCity, STATE,
Per diem 30 hours a week working different positions within the practice. Medical records, Front office representative, Scheduling, Switchboard.  All inclusive to the above job duties.  Switchboard duties included transferring incoming call to the appropriate department, staff member in a timely manor.  Patient messages being sent through the EMR with appropriate information to the primary nurse.  Medication request sent to the primary nurse.  Medicaid insurance verifications, patient confirmations and general phone duties.  Completing patient demographic reports to ensure accuracy of data.   

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Resume Overview

School Attended

    Job Titles Held:

    • Managed Care Specialist
    • Scheduling
    • Medical Records Clerk
    • Front office Representative / Switchboard Per diem

    Degrees

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