qualification summary

 

proven administrative professional in the medical industry, efficient in creating and maintaining a positive flow of work by utilizing what resources and facilities are available to maximize efficiency. long-respected for advanced abilities in medical office administration, business development, service knowledge, client relations and account management. outstanding blend of expertise in staff leadership, communication with physicians and clinic representatives, creative problem solving, and driving projects to meet strict timelines. excels at building relationships, fusing resources, and advancing organizational directives through innovative programs and initiatives.

 

account management / business development / strategic planning

relationship management / professional services / quality assurance

team building & motivation

career history

 

qtc medical services, atlanta, ga

quality assurance specialist, 06/2008 c present

• directed the professional success of 5-member staff during two-year tenure with the organization.
• assess and understand medical and psychiatric reports and determine if procedures were properly followed.
• modify reports as necessary to obtain compliance with qtc and va established standards.
• skillfully advised medical doctors on ways that reports could adhere even closer to the standards of the company.
• interact with claimants during paperwork processing phase and address claimants concerns with the status of individual cases.

 

case coordinator, 03/2007 c 06/2008

• demonstrated proficient client services by utilizing verbal and written communication skills to resolve concerns with clients, providers, and claimants, and process providers /claimants documents.
• completed quality assurance assessments of medical services and reports.
• implemented organizational and data management skills in processing bills, preparing files and charts, and acquiring diagnostic documentation.
• triaged cases and built better interpersonal relations with claimants and physicians.

 

healthbridge product and reimbursement, inc., braintree, ma

reimbursement advocate, 08/2005 c 10/2006       

• obtained maximum reimbursement figures on clients and patients behalf.

 

 

• researched patients eligibility for insurance benefits utilizing icd-9/cpt coding and by interacting with medical office representatives.
• tracked accounts and updated status after discussions with patients, patient s families, national payers, homecare, and medical doctor s office representatives.
• utilized time management and problem identification abilities to triage incoming calls from patients, medical offices and homecare pharmacies based on the level of importance.
• updated and managed database contents, assessed patient enrollment, and monitored coverage level, and patient eligibility in uninsured patient programs, such as county level programs, medicaid, state ins pools, ssdi, and ltd.
• secured coverage and services for patients from medical provider by obtaining a clear understanding of eligibility criteria.

 

boston public health commission, boston, ma

administrative assistant, 10/2003 c 08/2005

• performed secretarial duties utilizing specific knowledge of medical terminology, icd-9/cpt coding, and hospital, clinic, or laboratory procedures.
• engaged in scheduling appointments, billing patients, and compiling and recording medical charts, reports, and correspondence.
• carefully addressed medicaid and private insurance billing concerns; advised patients on how to secure free healthcare from hospital clinical facilities.

 

education

bachelor of arts in child development and biomedical engineering, may 2003

tufts university, medford, ma