- Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
- (555) 432-1000
- resumesample@example.com
Driven Healthcare professional with 15 years of hands on experience in a
fast-paced healthcare environment. Very motivated and compassionate
about my work and job duties. Patient care and wellness is my strong
focus which I'm very responsible and accountable for. Highly
professional and organized Healthcare Industry with a solid experience
in managing and overseeing daily office operations in healthcare as well
as coordinating medical and administrative staff to deliver high-quality
Healthcare services. Possess excellent communication, leadership, and
multi-tasking skills along with the basic knowledge of medical principles,
terminology, laws, and ethics to ensure smooth running of medical
practice. Well organized and detail-oriented with the skill to grasp
complex situations. Experienced in HEDIS,
NCQA and CMS guidelines
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Computer: HEDIS, NCQA, CMS, |
Wexford Health Sources Inc – Belleville, IL,
- Perform complaint and quality investigations related to
manufacturing, design or clinical use issues.
Review and approve investigations performed by OEM supplier - Managed large volume of medical claims on daily basis.
- Ensure consistency to detail in performing and documenting
complaint investigations - Evaluates complaints for determining MDR/Vigilance events and
document rationale for not filing
MDRs - Determine whether a product malfunction or serious injury reports
needs to be filed with the FDA. - Determine whether a 30 day or 5-day MDR report is required.
- Maintain the records of all MDRs and document rationale for not
filing MDRs - Create MDRs for review by the Clinical Risk Specialist and also
develop inquiry reports to the hospitals
on reported complaints. - Perform final review for closure of complaint files to ensure accuracy,completeness, and attention to
detail. - Generates results letters to customers and maintain all required
records for the complaint. - Approve decision trees for vigilance reports/international competent
authority - Handle competent authority inquiries of complaints and Other duties
as assigned.
Healthcare Consultants – City, STATE,
- Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
- Plans, implements and evaluates Epic ambulatory EMR and professional revenue cycle training
- Maintain a central database on practice management applications by practice: users, locations, use of scheduling system, automated encounter form, etc
- Assists in the development and maintenance of the policy and procedure and training manuals
- Set training schedules and review expectations with Hackensack University Medical Group physician practice staff and leadership
- Assist with quality control review of processes and daily monitoring of status of backlogs
- Develop agenda and facilitate Front End Users meetings to disseminate information on revenue cycle operations to designated physician practice staff
Healthcare Consultant – City, STATE,
- Assured consistent quality of production by implementing and enforcing automated practice systems.
- Developed quality improvement plans, policies and operational
guidelines. - Provide team leadership and project management
- Extracted, transformed and loaded data utilizing SAS ETL studio
Responsible for researching health data and records by interpreting
patient data into reports - Compile and analyze patient claims to access performance and
efficiency relative to available medical models - Develop and provide regular reports from company's vendors and
customers - Review all data from a variety of sources to ensure integrity, validity
and accuracy - Assist with structuring of request programming
- Create data sets for analysis using database and analytic tools
- Provide analytic support to patient quality improvement teams
Liberty Nursing&Rehab Center – City, STATE,
- Identified new methods to optimize medical records management.
- Maintained accuracy, completeness and security for medical records
and health information. - Adhered to all confidentiality requirements at all times.
Demonstrate initiative by organizing and closing out all charts of
residents in a 281 bed facility. - Research all current and closed charts for appropriate forms and
signatures. - Participated in committees to discuss topics, including electronic
health records and methods that would improve overall workflows. - Manage a team of Ward clerks, and assist in their daily routines of
maintenance of the medical records. - Designed and introduced leadership development, coaching and team
management model, resulting in promotion of employees into
increased levels of responsibility. - Take on weekends duties, helped mealtime preparation, and perform
hall monitoring. - Create a functioning file method of filing medical records within
compliance of the State of North Carolina. - Handle all aspects of Medicare Certifications, and Re-Certification
Columbia Southern University - Orange Beach, AL
Next Level Healthcare Training - Atlanta, CA,
Kennesaw State University - Kennesaw, GA,
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Resume Overview
School Attended
- Columbia Southern University
- Next Level Healthcare Training
- Kennesaw State University
Job Titles Held:
- Medical Legal Assurance Specialist
- Practice Operations Training Analyst(promotions)
- Healthcare Analyst/ Quality Improvement Specialist
- Medical Records Director
Degrees
- Bachelor of Science
- CERTIFICATE
- Certificate
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