Reliable individual bringing 12 years of experience in healthcare environments. Maintains positive relationships with case managers and providers. Remains polished and calm under extreme stress.
Overview
12
12
years of professional experience
Work History
Utilization Management Coordinator
PIH Health Hospital
11.2017 - Current
Performed prior authorization review of services requiring notification.
Obtained authorizations from multiple insurance carriers for various levels of care.
Answered constant flow of customer calls with minimal wait times.
Streamlined call center processes for improved efficiency and reduced wait times.
Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Medical Assistant
PIH Health Hospital
10.2012 - 11.2017
Scheduled appointments, registered patients, and distributed sample pharmaceuticals as prescribed.
Verified patient insurance coverage and collected required co-payments.
Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Obtained and documented patient medical history, vital signs and current complaints at intake.
Education
Vocational - Medical Assisting
Bryman College
05.2004
High School Diploma -
Garey High School
06.1999
Skills
Patient Health Information Access
Computerized Maintenance Management Systems
CPT Coding
Skilled in EMR / EHR / EPIC / EZ CAP
Microsoft Office
HIPAA Compliance
Patient Data Management Systems
Process Knowledge
Utilization Review
Patient Interaction
Obtaining Authorizations
Quality Patient Care
Timeline
Utilization Management Coordinator
PIH Health Hospital
11.2017 - Current
Medical Assistant
PIH Health Hospital
10.2012 - 11.2017
Vocational - Medical Assisting
Bryman College
High School Diploma -
Garey High School
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