Medical Professional with over 20 years experience in multi-physician clinical practices. Working within pressurized environments. Recognized for the ability to successfully manage tasks and priorities. A self directed worker with an excellent work ethic.
Overview
7
7
years of professional experience
Work History
Utilization Management Intake Coordinator
Longevity Healthplan
Eagan, MN
03.2023 - Current
Processing of Medical Faxes received via Email
Duties include Authorization processing and creation
Through examination of received Authorization request checking for any HIPPA violations l.e Name, Date of birth etc
Reviewing the fax for pertinent information such as request details, Inpatient or Outpatient request, Urgent, or Non-Urgent
During the fax triaging process if an error arises, the sender is contacted for confirmation of any issues that may arise
Duties also include Admission and Observation census as well as creating new Authorizations for members newly admitted to the Hospital
Duties also include assisting facilities and providers with any questions or concerns
During the course of my day I reach out to UM Departments requesting any clinicals needed for proper case review
Utilization Management Coordinator
Highmark Blue Cross Blue Shield of Delaware
Wilmington, DE
03.2020 - 12.2023
Efficient processing of Medical faxes from Providers as well as Medical Facilities
Responsible for initiating the triage process for Case build
Duties include fax retrieval, Careful review of patient data to confirm patient name and date of birth are a match to the Highmark database
Reviewing the fax for pertinent information such as request details, Inpatient or Outpatient request, Urgent, or Non-Urgent
During the fax triaging process if an error arises, the sender is contacted for confirmation of the questioned section, or the sender would be advised the fax will be returned for proper submission
If all is well the fax request has been triaged at that point the fax is forwarded to the case build team for case setup
Lead Front Desk Coordinator
Einstein Medical Center
Philadelphia, PA
04.2018 - 02.2020
Lead and Coordinated the Hepatology Department for a fast paced Transplant Unit
Duties included but not limited to
Schedule review and coordination with Providers and Care managers
Appointment scheduling and rescheduling as needed depended upon physician availability
Copay collection as well as reconciliation
Assist other departments within the practice for any questions relating to the Hepatology Department