Andrea Jules
Valley Stream,NY
Summary
Enthusiastic and Energetic seasoned health care professional with many years of experience in patient care, administrative support and member resolution. Expert in facilitating communication with providers, managing member services, and ensuring compliance with healthcare protocols. A team player and leader who is very committed to professional growth and development, while being able to complete any task in a timely manner.
Overview
20
20
years of professional experience
Work History
Clinical Support Coordinator
Health First
11.2020 - Current
- Coordinate health navigation and assistance for members, ensuring timely scheduling of appointments and risk assessments screening.
- Facilitate communication with healthcare providers to secure necessary authorizations, referrals, and coordinate member visits.
- Documents accurate member information in compliance with Internal procedures.
- Timely communicate member’s issues or needs and monitors screening of members to effectively improve quality and cost outcome.
- Monitor member screenings to enhance quality of care and cost efficiency, exhibiting proficiency in managing DME, CDPAS and PCA initiatives.
Clinical RightFax Coordinator
Health First
04.2010 - 11.2020
- Manage the systematic distribution and attachment of incoming requests and communication from providers to appropriate case management folders streamlining information flow.
- Coordinate with providers and hospitals to secure necessary authorizations for medical procedures, enhancing member service effectiveness.
- Generate accurate authorizations for member services and procedures, ensuring compliance with health care protocols and access to care.
Clinical Research Coordinator
North American Partners in Pain Management
09.2005 - 04.2010
- Managed the execution of clinical trials In conjunction with the Principal Investigator, ensuring compliance with study protocols and ethical guidelines.
- Prepared and maintained essential regulatory documents, including Industry Review Board ( IRB ) and National Institutes Of Health ( NIH ) submissions, throughout the progression of research studies.
- Conduct medical procedures required by study protocols and screen schedule and conduct patient visits per specific study
- Coordinated patient visits, conducted medical procedures as outlined in study protocols, and accurately handled laboratory tests including Blood draw, EKG and vitals also documentation for case reporting.
Medical Assistant
Thomas Koutelous M.D.
03.2005 - 08.2005
- Efficiently managed appointment scheduling, prescriptions coordination, and insurance verification to maintain office operation and excellent patient care.
- Maintenance of front office, examination rooms and medical utensils ensuring cleanliness and safe environment for patients.
- Assisted with clinical tasks, including conducting vital sign check. Phlebotomy, EKG’s and supporting medical examinations, while ensuring accurate updates to patient medical records.
Education
CPT: Current Terminology/ Codes Medical Billing/ Invoice ICD-10-CM/ PCS Coding Letter of Completion available upon request. -
Nassau Community College
Garden City, New YorkMedical Assisting Certificate -
Allen School Inc.
Brooklyn, New York09.2005
Caribbean Examination Council Secondary Certificate -
Bishop’s Centenary College
Trinidad and Tobago, WI06.1993
Skills
- Familiarity with medical terminology
- Knowledge of CPT and ICD-9 codes
- Knowledge of MS Word, Excel, Outlook, and Power point
- Strong organizational skills
- Good communication (verbal and written) and interpersonal skills
- Ability to resolve member issues with patience and courtesy
- Competent in managing responsibilities in high-volume, Fast paced, Evolving atmosphere
- Flexibility, reliability, and easily adaptable to any work assignments or new computer applications
- Empathy,
- Time Management
- Conflict Resolution and Problem Solving
- Communication, Patient engagement
- Organization
- Teamwork
Timeline
Clinical Support Coordinator
Health First
11.2020 - Current
Clinical RightFax Coordinator
Health First
04.2010 - 11.2020
Clinical Research Coordinator
North American Partners in Pain Management
09.2005 - 04.2010
Medical Assistant
Thomas Koutelous M.D.
03.2005 - 08.2005
CPT: Current Terminology/ Codes Medical Billing/ Invoice ICD-10-CM/ PCS Coding Letter of Completion available upon request. -
Nassau Community College
Medical Assisting Certificate -
Allen School Inc.
Caribbean Examination Council Secondary Certificate -
Bishop’s Centenary College