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Utilization Review Coordinator Resume Example

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Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary

I am a focused Chiropractor committed to helping patients manage pain and injuries utilizing diversified chiropractic adjustments, instrument assisted soft tissue techniques, and various other conservative treatment protocols. I am proficient in all areas of the body's neuromusculoskeletal system and methods for improving range of motion and reducing pain. I am skilled in monitoring results and prescribing exercises for long-term health. Overall, I am an enthusiastic Chiropractor eager to contribute to team success through hard work, attention to detail and excellent organizational skills. I obtain a clear understanding of physical and neurological examination skills, conservative treatment protocols and I am committed to continuing my knowledge of all aspects of Chiropractic care and practice management.

Skills
  • Diversified CMT
  • Various soft tissue manipulative therapies
  • Functional rehab exercises
  • Records management specialist
  • Skilled in patient relations
  • Vital sign assessment
  • Patient assessment
  • Therapy planning
  • Contract negotiation
  • Microsoft Office
  • Records administration
  • Discharge planning
  • ADL support
  • Documentation review
Work History
Doctor of Chiropractic , 03/2021 to Current
Promises Addiction Treatment CenterWimberley, TX,
  • Conducted patient history reviews and physical, neurological and orthopedic examinations to assess conditions and present disorders.
  • Teamed with other physicians, specialists and health care providers to provide well-rounded care for complex cases.
  • Diagnosed neuromusculoskeletal conditions and performed corrective adjustments.
  • Instructed and advised patients regarding preventive health care measures to promote early detection, diagnosis and management of medical conditions.
  • Accessed and documented medical backgrounds and ordered diagnostic images to determine health problems.
  • Developed and implemented performance improvement strategies and plans to promote continuous improvement.
Associate Chiropractor, 06/2020 to 10/2020
Mitek Industries, Inc.Houston, TX,
  • Diagnosed neuromusculoskeletal conditions and performed corrective adjustments.
  • Conducted patient history reviews and physical, neurological and orthopedic examinations to assess conditions and present disorders.
  • Used techniques such as diversified chiropractic adjustments, activator adjustments, drop table adjustments, soft tissue manipulation procedures, KT taping, and prescribed corrective exercises regularly to improve range of motion.
  • Reviewed diagnostic imaging results with patients to educate them on current conditions and treatment necessity.
  • Accessed and documented medical backgrounds and ordered diagnostic images to determine health problems.
  • Implemented pain management strategies and specialized operations to improve patient health and reach recovery objectives.
  • Counseled patients about lifestyle choices impacting injuries, conditions and recovery.
Utilization Review Coordinator, 04/2014 to 09/2016
AspirusPlover, WI,


  • Used Officaeally, Soapware, Kipu, and Bestnotes software to chart patients' progress and update departmental records with data according to healthcare documentation regulation.
  • Interpreted results and proposed intervention plans, including short and long-range goals, frequency and duration.
  • Performed various administrative functions, including filing paperwork, delivering mail, sorting mail, office cleaning and bookkeeping.
  • Discussed clinical notes with insurance companies to receive authorization for treatment.
  • Verified insurance benefits.
  • Medical billing and coding.
  • Proficient in various software such as Officeally, Soapware, Kipu, Bestnotes, Lytec, Trizetto gateway EDI, Word, Excel, and PowerPoint.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Followed up with insured individuals regarding premium and deductibles payments.
  • Performed prior authorization review of services requiring notification.
  • Obtained authorizations from multiple insurance carriers for various levels of care.
  • Supervised and maintained all utilization review documentation through various software.
  • Facilitated workgroup meetings with medical personnel to find effective solutions to issues.
  • Performed admission reviews based for medical necessity.
Receptionist Administrative Assistant, 09/2013 to 04/2014
Elwood Cohen D.O.City, STATE,
  • Minimized interruptions for office team members by screening incoming calls and visitors.
  • Facilitated efficient communication and office operations by sorting and distributing business correspondence and packages to team members.
  • Managed all customer service and administrative functions including updating calendar, preparing documents and coordinating deliveries.
  • Sorted, opened and routed incoming correspondence and deliveries to help senior leaders respond quickly to business and customer requirements.
  • Created and updated physical records and digital files to maintain current, accurate and compliant documentation.
  • Produced highly accurate internal and external office collateral, communications and forms such as letters and memoranda.
  • Delivered top-notch administrative support to office staff, promoting excellence in all areas of office operations.
  • Transferred and directed phone calls, guests and mail to correct staff members.
  • Kept reception area clean and neat to give visitors positive first impression.
  • Supported company leaders by managing budgets, scheduling appointments and organizing itinerary.
  • Answered multi-line phone system and asked open-ended questions to transfer callers to appropriate department or staff member.
  • Patient check-in ands scheduling.
  • Collected payments.
Medical Receptionist, 02/2011 to 08/2012
Company NameCity, State,
  • Enhanced office efficiency by handling 100+ callers per day.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Maintained current and accurate medical records for over 500 patients.
  • Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
  • Completed skilled administrative work to support all office staff and operational requirements.
  • Managed master calendar and scheduled appointments for three providers based on optimal patient loads and clinician availability.
  • Completed and filed financial documentation for accounting purposes.
  • Checked patient data including insurance, demographic and health history to ensure all information was current.
  • Adhered to strict HIPAA guidelines at all times to protect patient privacy.
  • Scheduled appointments for doctor visits and procedures using desktop calendar software.
  • Carefully wrote down all phone messages and relayed to appropriate personnel within 5 minutes of each call.
  • Promptly answered multi-line phone system and greeted callers enthusiastically.
  • Managed office logistics by scheduling appointments, maintaining files and collecting payments.
  • Responded to correspondence from insurance companies to verify patient's coverage.
  • Obtained payments from patients and scanned identification and insurance cards.
  • Scheduled, rescheduled and handled cancelled appointments for patients.
  • Carried out front office duties utilizing data entry skills in framework of medical database.
  • Supported providers in outpatient medical office through coordinating all administrative operations.
  • Located, checked in and pulled medical records for patient appointments and incomplete charts.
Education
Doctor of Chiropractic: Chiropractic, Expected in 12/2019
Southern California University of Health Sciences - Whittier, CA
GPA:
  • Graduated Delta Sigma
  • Dean’s List Spring 2018, Summer 2018, and Spring 2019
Bachelor of Science: Kinesiology, Expected in 06/2016
California State University- San Bernardino - San Bernardino, CA
GPA:
  • Member of Kinesiology Student Association
  • Member of Delta Epsilon Iota Honor Society
  • Dean's List Fall 2014 term - Spring 2016 term
: Transfer Credits , Expected in 12/2014
Crafton Hills College - Yucaipa, CA
GPA:
Affiliations
  • Member, American Chiropractic Association, 2018 to Current
  • Member, ICPA4kids, 2019 to Current
Certifications
  • CPR, First-Aid, and AED certified
References

Kellie King

Owner/CEO Medbilling Group

Former Employer

(909) 379-9237

Michael Wauhob

Owner/CEO Omega Design Group

Family Friend

(760) 964-6521

Cynthia Cooper, DC

Doctor of Chiropractic

Former Mentor

(714) 330-0700

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Resume Strength

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  • Personalization
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Resume Overview

School Attended
  • Southern California University of Health Sciences
  • California State University- San Bernardino
  • Crafton Hills College
Job Titles Held:
  • Doctor of Chiropractic
  • Associate Chiropractor
  • Utilization Review Coordinator
  • Receptionist Administrative Assistant
  • Medical Receptionist
Degrees
  • Doctor of Chiropractic
  • Bachelor of Science

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