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Program Specialist Resume Example

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PROGRAM SPECIALIST
Professional Summary

Highly successful Program Specialist proficient at executing financial administration, reporting and scheduling functions. Strong leadership and interpersonal communication abilities with expertise in working with teams of professionals in high-volume settings.

Skills
  • Group and individual instruction
  • Performance assessments
  • Skill Development
  • Data management familiarity
  • Financial administration
  • Client records management
  • Persuasive communication style
  • Vendor management
  • Generating schedules
Work History
04/2003 to Current
Program SpecialistTemple University – Philadelphia , PA
  • Acts as a liaison between our hospital and at least five different VA facilities, as well as private facilities to coordinate treatment requests for up to 150 consults weekly
  • Ensures eligibility for VA medical care is met and accompanies each consult/fee basis request. If eligibility is not met, or if information submitted is insufficient to make this determination, so informs the appropriate party
  • Serves as primary contact with medical staff in advising them of eligibility determinations, to include the concept of medical versus legal eligibility and advising them of alternative resources such as fee basis or community referrals
  • Receives numerous telephone inquiries. Uses proper telephone etiquette, being courteous at all times, for a wide array of questions and problems. Screens calls for physicians , initiates Reports of Contact, when necessary, and completes follow-up action. Frequently receives unclear inquiries, determines the nature of the call and responds appropriately
  • Submits consults from Saginaw to other VA facilities to include eligibility and necessary medical information, when required
  • Reviews the medical content of each consult and ensures the referral is appropriate as addressed, then either schedules to correct clinic, arranges admission, or sends for review by clinic directors, according to established guidelines
  • Obtains information on changes in laws and regulations which impact basic veterans' medical benefits entitlement
  • Is constantly alert to medical content of consults and physicians' orders so that appropriate action is taken concerning urgency, and follows through by coordinating correct action and notifying veteran. Reviews each referral for geographic location of veteran's primary residence and coordinates final referral to nearest appropriate VA medical facility
  • Incumbent manages and coordinates fund control point activities for the fee-basis services, contract hospitalization, homemaker/health aid, beneficiary travel, and CBOC activities
  • Maintains a current knowledge of policies and procedures, and is available for questions and problems which arise daily
  • Follows-up on problems, looking for and presenting solutions to the supervisor. Coordinates the needs of the Clinical Services and prepares recommendations for hospital management's coordination
  • Is well versed in all VISTA functions and performs satisfactorily as required by the position
  • Assists in orienting and advising physicians in VA regulations, policies, and procedures on patient care in regard to administrative matters
  • Responsible for quality, accuracy, and timely submission of all assigned reports. Reports are recurring and nonrecurring and require manual tracking methods to ensure validity. Assists in preparation of congressional correspondence and other reports, as requested
  • May be delegated to perform special duties or tasks by the Supervisor. Must have a thorough knowledge of current and amended regulations and be able to apply this knowledge to available records.
  • Thorough knowledge of VA procedures as well as technical knowledge of the purpose and functions of all services within the hospital and satellite clinics
  • Knowledge of the organization of the patient's medical records necessary to assemble and disassemble records, file test results, retrieve needed information, and to review records for completeness and accuracy by other members of the patient care team
  • Knowledge of a wide variety of forms is required
  • Knowledge of medical terminology pertaining to various tests and procedures and specialty consultants in order to interpret doctors orders. Doctor's orders are frequently illegibly written, abbreviated, or incomplete and usually deciphered independently by the incumbent in their absence. Therefore, a functional knowledge will enable incumbent to skillfully interpret and transcribe intent
  • Must have knowledge of geographic location of cities/town within Michigan in order to accept/submit referrals to nearest appropriate VAMC and to coordinate appointments more efficiently
  • Incumbent must be a qualified typist and become intricately familiar with the use of computers with knowledge/skill in all functions required in the performance of duties
  • In the performance of official duties, employees have regular access to printed and electronic files containing sensitive data, which must be protected under the provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA statutes and policy, and VHA policy. The employee is responsible for (1) Protecting the data from unauthorized release or from loss, alteration, or unauthorized deletion and (2) following applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in the computer access agreement which the employee signs
  • Must have strong interpersonal skills, as specialized skills are required for maintaining customer relations and monitoring timeliness of service. Interacts with peers and/or internal and external customers in a manner that portrays a positive image of Service and facility. Tact and professionalism will be maintained at all times
  • Worked alongside other professionals to outline and implement program plans and objectives
06/2002 to Current
Patient Services AssistantDepartment Of Veterans Affairs – Billings , MT
  • Reviewing first party receivables
  • Collecting, compiling and/or tracking of data and program information in support of revenue
  • Preparing, executing and/or tracking revenue program specific information
  • Organizing and retrieving computerized data, generating reports of data, reviewing data for inconsistencies and referring to appropriate area for completion
  • Entering information into tracking system and maintaining accurate program specific data for maximum reimbursement
  • Conducting proactive accounts receivable follow up and analysis on various account receivables
  • Responsible for the coordination of billing of worker's compensation or tort cases
  • Providing patient education and assistance concerning Medical Care Cost Fund Program
  • Providing answers to customer service inquiries regarding accounts receivable, means and co-payment testing and health insurance related issues
  • Reviewed and corrected claim errors to facilitate smooth processing
  • Performed duties in accordance with all applicable standards, policies and regulatory guidelines to promote safe working environment
01/2001 to Current
Release of Information Clerk/Switchboard OperatorAleda E Lutz VAMC – City , STATE
  • Obtained veteran permission and signatures to release information to the veteran or send results or medical records to outside facilities or providers
  • Ensured we had the proper authorization to release information to outside entities to include lawyers or insurance companies
  • Reproduced protected health information by using variety of technologies, including, data extraction and file management techniques
  • Navigated within patient records to locate requested documentation, successfully completing over 50 requests per day
  • Accurately pulled patient records for upcoming appointments and procedures, typically within 8-hour period
  • Handled variety of phone calls from attorneys, insurance companies and patients, including medical/dental and auto insurance inquiries
  • Date stamped requests and highlighted pertinent data to facilitate processing
  • Communicated effectively with staff, patients and insurance companies by email and telephone
  • Kept accurate log of all requests for medical information and records
  • Interacted and communicated easily with department personnel and public
  • Maintained accuracy, completeness and security for medical records and health information
  • Connected callers with appropriate professional, department or business
  • Performed clerical work such as sorting mail, restocking supplies and typing documents
  • Created and maintained company phone directory with current extensions and staff information
  • Answered calls on first ring and engaged customers with friendly, professional demeanor
  • Managed multi-line switchboard system for busy hospital
  • Announced important information and emergency notifications over PA system
  • Directed incoming calls to internal personnel and departments, routing to best-qualified department
  • Managed telephone switchboard of 500 personnel and routed internal and external calls to provide quick connection
  • Operated digital paging system to notify recipients of incoming calls
  • Maintained up-to-date knowledge of emergency call procedures
  • Attended safety training meetings to learn procedures for handling medical and fire emergency calls
Education
Some College (No Degree)Delta College - City, State
Some College (No Degree)Davenport University - City
06/1990
High School Diploma
South Side High School - City, State
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Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

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Resume Strength
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  • Formatting
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Resume Overview

School Attended

  • Delta College
  • Davenport University
  • South Side High School

Job Titles Held:

  • Program Specialist
  • Patient Services Assistant
  • Release of Information Clerk/Switchboard Operator

Degrees

  • Some College (No Degree)
    Some College (No Degree)
    High School Diploma

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