Deanna Okoneski
Mankato,MN
Summary
Dynamic Utilization Management Assistant at CentraCare Health System with expertise in clinical data analysis and compliance documentation. Proven track record in enhancing resource management and training staff, while maintaining HIPAA compliance. Recognized for attention to detail and problem-solving skills, driving improvements in utilization review processes and ensuring accurate documentation. Resourceful Utilization Management Assistant known for high productivity and efficient task completion. Skilled in medical coding, healthcare policy compliance, and patient data analysis. Excel in communication, problem-solving, and time management, ensuring smooth operations in fast-paced environments.
Overview
19
19
years of professional experience
Work History
Utilization Management Assistant
CentraCare Health System
Saint Cloud, Minnesota
10.2006 - Current
- Analyzed clinical data to support decision-making in resource management.
- Assisted healthcare providers with documentation and compliance processes.
- Maintained accurate records within the electronic health record system for audits.
- Supported training sessions for staff on utilization management protocols and tools.
- Performed retrospective reviews on high dollar claims and developed action plans accordingly.
- Interpreted medical record documentation to determine if requested services meet criteria for authorization.
- Assisted in the preparation of reports on utilization review activities.
- Acted as a liaison between providers, payers, members and other stakeholders when resolving issues related to authorization status or payment discrepancies.
- Assisted with training new personnel on departmental processes and procedures related to utilization management.
- Analyzed claims data using various software applications such as Excel, Access.
- Supported clinical staff in the development of new policies and procedures related to utilization management processes.
- Maintained accurate documentation related to all aspects of utilization management functions including denials, appeals, and grievances.
- Updated internal databases with current information regarding authorizations, denials, appeals.
- Monitored utilization patterns, identified trends in utilization and reported findings to management.
- Collaborated with Utilization Management staff to develop improvement strategies for managing utilization of services.
- Maintained confidentiality of records relating to clients' treatment
- Submitted diagnosis and procedure codes for insurance companies.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Communicated with patients with compassion while keeping medical information private.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
- Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
- Completed relevant insurance and other claim forms.
Education
Bachelor of Arts - Health Administration
Ashford University
Clinton, IA06-2012
Skills
- Clinical data analysis
- Utilization management
- Compliance documentation
- Electronic health records
- Data reporting
- Process improvement
- Healthcare regulations
- Issue resolution
- Problem solving
- Attention to detail
- Time management
- Team training
- Confidentiality management
- Utilization review expertise
- Documentation accuracy
- Healthcare systems
- Organizational growth
- Problem solving prowess
- Goal-oriented focus
- HIPAA compliance awareness
- Insurance verification experience
- Medical terminology
- Conflict resolution techniques
- Case management proficiency
- Professionalism and ethics
- Critical thinking aptitude
- Resourcefulness and initiative
- Continuous learning mindset
- Positive attitude
- Office administration
- Multitasking and organization
Timeline
Utilization Management Assistant
CentraCare Health System
10.2006 - Current
Bachelor of Arts - Health Administration
Ashford University