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MIS Manager Resume Example

Resume Score: 90%

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MIS MANAGER
Professional Background
A challenging position, utilizing my abilities developed through my experience and education, with the opportunity for professional growth.
Skill Highlights
  • Type 60 wpm, 10-key
  • Fast learner - able to adjust and perform on any operating system
  • Excellent leadership and communication skills
  • Vast knowledge of medications, their uses and contraindications
  • Familiar with billing codes primarily for Medi-Cal/Medi-Care patients
  • Coordinated Accreditation processes
  • Multi-tasking - fast-paced environments

Accomplishments
  • Management Seminars Sexual Harassment Seminars Seminars for CE credits related to several areas of Healthcare Staff Training and Recognition Program - Member Service Seminars by CUNA League Services.
Professional Experience
MIS Manager05/2010 to CurrentD'VEAL FAMILY AND YOUTH SERVICES
  • Supervisory functions include training, creating and delegation of projects, and time and attendance management of the MIS and other departments' staff.
  • Maintain, complete, compile and distribute monthly reports for the CEO and other affected departments.
  • Correct billed claims that were denied and re-submit such claims for reimbursement.
  • Maintain regularly scheduled audits of financial folders to ensure all information is updated and correct for outside audit purposes.
  • Responsible for quality assurance on all information and charts compiled for clients we service.
  • Liaison between organization and Clinitrak (in-house data processor).
  • Problem-solve and answer any Clinitrak program inquiries.
  • Ensure that the practices, policies and procedures are in compliance with the Agency's expectation, licensing requirements, and County, State and Federal standards.
  • Communicate with medical staff and other service providing departments to streamline processes that involve clinical and financial information processes.
  • Responsible for Integrated Behavioral Health Information System (IBHIS) testing and conversion, and implementation of training for new managed-care processes.
Pharmacy Manager/Certified Pharmacy Technician/Accreditation Coordinator/HIPPA Officer11/2005 to 04/2010WEBSTER'S
  • Supervised all pharmacy technicians, data entry and pharmacy clerk staff to perform daily pharmacy dispensing procedures in such a manner as to achieve our goal of superior quality service.
  • Trained all pharmacy staff on new workflow system; problem solved issues, developed and implemented new policies and procedures.
  • Provided support to pharmacist and pharmacy staff regarding system program changes, client information and other requests deemed important to them.
  • Scheduled and managed 10 employees, ensuring adequate coverage on shifts.
  • Monitored pharmacy technicians for accuracy and supervised staff in the proper preparation of medications to be dispensed by the pharmacist.
  • Compiled, monitored and reconciled billing statements for insurance claims submitted electronically and through mail.
  • Performed quality control procedures on all claims to ensure accuracy of billing, resolving any billing code errors and prepared for resubmission any claims billed to Medi-Cal and/or Medi-Care and supplemental coverage.
  • Initiated and followed-up with insurance companies on Prior Authorization requests for treatment.
  • Contacted insurance companies for resolution on claims that were outside of regular billing parameters, i.e.
  • drug-drug interactions, duplicate therapies, vacation supplies and lost and/or stolen medications; also pharmacy benefits.
  • Maintained compliance with all Federal, State and Corporate regulations, performing insurance audits and verifying insurance billing.
  • Responsible for performing Human Resources tasks, such as interviewing, hiring and terminating employees.
  • Initiated regularly scheduled staff meetings.
  • Single-handedly acquired the pharmacy's accreditation successfully, in order to continue providing services to Medi-Cal/Medi-Care patients.
  • This involved creating and updating procedures to comply with CMS standards and also improved current processes.
Pharmacy Technician02/2000 to 11/2005WEBSTER'S
  • Reviewed doctor orders for completeness, legibility or missing information.
  • Deciphered prescriptions, entered data into pharmacy system for labeling, filled and labeled prescriptions with accuracy.
  • Made aware of drug interactions and brought them to the pharmacist's attention before dispensing medications.
Education and Training
Registered Pharmacy TechnicianNorth-West College
AAPasadena City College
DiplomaBlair High School
General Courses Ambassador Beauty College - Cosmetologist State LicenseGlendale Community College
BSCalifornia State UniversityLos Angeles
Bachelor's Degree: Health Care AdministrationAshford University
Skills
10-key, streamline, Agency, benefits, billing, charts, CMS, conversion, client, clients, data entry, financial, hiring, Human Resources, insurance, team-leader, meetings, mail, MIS, operating system, policies, problem-solver, processes, quality, quality assurance, quality control, fast learner, self-motivated, Supervisory, Technician, Type 60 wpm, well organized, workflow
Additional Information
  • PTCB Exam - Certified Registered Pharmacy Technician * Personal references are available upon request
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Resume Overview

Companies Worked For:

  • D'VEAL FAMILY AND YOUTH SERVICES
  • WEBSTER'S

School Attended

  • North-West College
  • Pasadena City College
  • Blair High School
  • Glendale Community College
  • California State University
  • Ashford University

Job Titles Held:

  • MIS Manager
  • Pharmacy Manager/Certified Pharmacy Technician/Accreditation Coordinator/HIPPA Officer
  • Pharmacy Technician

Degrees

  • Registered Pharmacy Technician
    AA
    Diploma
    General Courses Ambassador Beauty College - Cosmetologist State License
    BS
    Bachelor's Degree : Health Care Administration

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