Buffie M. Hildebrand
Summary
Resourceful Specialist offering expertise in problem-solving, data analysis and customer service. Adept at quickly learning new technologies and processes for driving success. Proven track record of successfully managing multiple projects and developing innovative solutions.
Overview
20
20
years of professional experience
Work History
Auth Specialist
CNS Professional Services
01.2021 - Current
- Call insurance companies to collect benefit information as well as request required prior approval for all home infusions
- Work with patients to ensure they are covered for prescribed procedures
- Interpreted clients' needs and introduced services to fit specific requirements.
- Please ask for additional information regarding this position
Clinical Administrative Coordinator – Administrative Assistant
OptumCare Utah
07.2015 - 11.2021
- Manage administrative intake of members or the admission/discharge information post notification
- Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providers
- Manage the referral process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
- Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
- Work with hospital and skilled nursing facilities to obtain records needed for clinical review, create a good relationship with each hospital to be successful in processing their claims appropriately
- Please ask for additional information regarding this position
Medical Assistant
ICU Tech – ER Tech, Mountain West Medical Center/Tooele Clinic Corporation, Tooele Clinic
01.2003 - 03.2015
- Held several positions with this company, such as Med/Surg, Labor & Delivery, ER, and ICU floors during several years for both the Hospital and Clinics
- All Medical Assistant duties
- All ICU Tech duties
- All ER Tech duties
- Please ask for additional information regarding the positions held with this company
Education
Associates Degree - Health Sciences
Utah Career College
Skills
- Ability to lead others to accomplish excellent outcomes
- Excellent problem solver, great organizations skills and the ability to work well under stressful situations
- 10 plus years health care/managed care experience
- Team oriented and Strong Organizational Skills
- Computer skills with Excel-filtering and analyzing reports in Microsoft Excel, MS Word and Outlook, Adobe Acrobat, several charting systems
- Experience working with medical based claims and Healthcare Delivery/ Medical Field/ Medical Insurance
- Knowledge of Medicare processes, Medical Insurance experience
- Experience working with claims as well as knowledge of health care system processes
- Years of experience in the health care industry Medical/Healthcare experience in the Hospital, Clinic, and Healthcare Insurance environment, including ER
- Experience working remotely as a telecommuter
- Highly organized and able to juggle a lot of different projects at once
- Fifteen plus years in Customer Service and Experience with issue resolution
- Quality Assessments
- Experience working as a Business Segment Liaison and Culture Ambassador
- Corrective Actions
Timeline
Auth Specialist
CNS Professional Services
01.2021 - Current
Clinical Administrative Coordinator – Administrative Assistant
OptumCare Utah
07.2015 - 11.2021
Medical Assistant
ICU Tech – ER Tech, Mountain West Medical Center/Tooele Clinic Corporation, Tooele Clinic
01.2003 - 03.2015
Associates Degree - Health Sciences
Utah Career College