Bobbi Melnyk Beaston
Shirleysburg,PA
Summary
Highly motivated and detail-oriented professional with experience in HEDIS Pend Specialist, SBCO Sales Operations roles and Retrieval Associate. Eager to highlight critical thinking, adaptability, and leadership skills in various environments. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Proven track record in time management, problem solving, and organization to produce quality work while maintaining a high level of efficiency in a fast-pasted environment. I look forward to having my diverse skills utilized from HEDIS, Retrieval Associate and clinical background.
Overview
12
12
years of professional experience
Work History
Retrieval Associate
Optum
04.2024 - Current
- Coordinates and performs medical record collection using one of 7 collection methodologies
- Medical Record Collection Planning, Management and Performance
- Proficient in EMR Systems, Claim systems, and Episource
- Overall HEDIS and Risk Adjustment program knowledge
- Ability to sort and format data via Excel
- .Ability to navigate multiple EMR systems in order to obtain relevant medical records according to quality program and/ or HEDIS measure specifications.
HEDIS Pend/ SBCO Sales Operations Specialist
United Healthcare Group
06.2022 - 04.2024
- Responsible for daily support of 51-100 new business quoting and installation function. Work closely with account executives to maintain operational infrastructure supporting quoting and new sales.
- Frequent interaction with external Account Executives, brokers and/or agencies
- Internal and external customer relations
- Ability to multitask and work within mandated timelines and expectations
- Ability to prioritize and document work while navigating and updating various tracking systems with progression information
- Professional and thorough communication skills with internal and external customer relationships both written and verbal
Certified Registered Medical Assistant
Broad Top Area Medical Center
05.2017 - 06.2018
- Performed preliminary physical tests to accurately record results in patient history summary.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Educated patients about medications, procedures and physician's instructions.
- Contacted pharmacies to submit and refill patients' prescriptions.
- Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.
- Conducted insurance verification and pre-certification and pre-authorization functions.
- Completed EKGs and other tests based on patient presentation in office
Patient Financial Counselor
JC Blair Memorial Hospital
03.2012 - 05.2017
- Helped protect providers and facility from legal liabilities by proactively assessing risks.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Demonstrated leadership by making improvements to work processes and helping to train others.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Handled and resolved all insurance claim issues.
- Processed and approved financial aid applications
- Insurance verification, authorizations, coding, charge capture and billing.
- Payment posting, excellent customer service and data entry
- Working knowledge of Medicare and Blue Cross regulation
Education
Associate of Applied Science - Medical Assistant Specialist
Keystone Technical Institute
Harrisburg, PA02.1998
Skills
- Teamwork & Collaboration
- Mentorship & Leadership
- Adaptability
- Detail Orientated
- Organizational Skills
- Critical Thinking
- Claims and Medical Records Research
- Time Management
Software Skills
- Doc 360
- Facets
- Episource
- Various EMR systems
- Iset
- iLead
- Microsoft Office
Honors & Awards
HEDIS Pends Spotlight Award from Managers recognizing skills utilized.
Timeline
Retrieval Associate
Optum
04.2024 - Current
HEDIS Pend/ SBCO Sales Operations Specialist
United Healthcare Group
06.2022 - 04.2024
Certified Registered Medical Assistant
Broad Top Area Medical Center
05.2017 - 06.2018
Patient Financial Counselor
JC Blair Memorial Hospital
03.2012 - 05.2017
Associate of Applied Science - Medical Assistant Specialist
Keystone Technical Institute
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