Results-driven healthcare professional with 10+ years of progressive experience within the same organization, advancing from Unit Clerk to Utilization Review Specialist. Proven ability to improve operational efficiency, implement process improvements, and collaborate cross-functionally with Business Office, case management, and clinical teams. Recognized for strong analytical skills, leadership support, and driving compliance and financial outcomes. Seeking to transition into a Business Office Manager role.
Overview
12
12
years of professional experience
Work History
Utilization Review Coordinator
Brentwood Springs
4488 Roslin Rd. Newburgh, IN
05.2016 - Current
Partner closely with Business Office, case management, and providers to ensure accurate authorizations, billing alignment, and timely reimbursement processes
Developed and implemented internal tracking spreadsheets to improve accuracy, accountability, and workflow efficiency across utilization review processes
Conduct utilization reviews to ensure medical necessity and compliance with payer guidelines, reducing denials and supporting revenue cycle integrity
Collaborate with interdisciplinary teams to coordinate care, improve patient outcomes, and support discharge planning
Serve as a key liaison between clinical staff and insurance providers, expediting approvals and reducing delays in care
Support leadership in setting departmental goals, tracking performance metrics, and identifying opportunities for process improvement
Maintain strict compliance with regulatory standards and ensure accurate, audit-ready documentation
CNA
HealthSouth Rehabilitation
Evansville
02.2014 - 05.2016
Enhanced patient satisfaction by providing compassionate and attentive care.
Assisted patients with daily living activities, promoting independence and dignity.
Collaborated with interdisciplinary healthcare teams to develop and implement individualized care plans for patients.
Ensured prompt response to call lights, addressing patient needs in a timely manner.
Prevented bedsores by regularly repositioning patients and implementing proper wound care techniques.
Administered prescribed medications under the supervision of a registered nurse, ensuring adherence to safety protocols.
Education
CNA - Nursing
Ivy Tech Community College of Indiana
Indianapolis, IN
09-2006
College-prep -
Benjamin Bosse High School
Evansville, IN
05-2004
Skills
Healthcare Operations & Workflow Improvement
Utilization Management & Case Review
Business Office Collaboration
Process Improvement & Systems Development
Regulatory Compliance (HIPAA, Medical Necessity)
Data Tracking & Reporting (Spreadsheets / Audits)
Cross-Functional Leadership
Communication & Team Coordination
Accomplishments
Improved workflow efficiency through custom tracking systems and process enhancements
Strengthened collaboration between Utilization Review and Business Office functions
Contributed to reduced readmissions and improved authorization turnaround times
Utilization Review Coordinator at MaineHealth Maine Medical Center BiddefordUtilization Review Coordinator at MaineHealth Maine Medical Center Biddeford