Judy Brightman
Senior Order Qualification Specialist
Portland,OR
Summary
Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
4
4
years of professional experience
Work History
Equipment Care Specialist-1 and 2
- Provide first-line communication with a variety of customers, referral sources, and clinicians to facilitate ordering and delivery of home medical equipment (HME) products, supplies and services.
- Communicate, educate, and advise patients and clinicians on a broad portfolio of HME products, supplies and services.
- Recommend medically appropriate, cost-effective products, supplies or services to meet individual patient requirements.
- Provide basic technical support for HME products and supplies.
- Obtain minimum data sets from referral sources required to process HME orders.
- Complete order entry in transaction system for delivery of HME orders
- Perform insurance eligibility and benefit verification and obtain insurance authorization required for HME reimbursement.
- Perform medical necessity evaluation of HME orders including interpretation of diagnosis, physician record, and payer medical policy.
- Gather all medical documentation required for medical necessity interpretation.
Commercial Lending/File Management Specialist
US Bank
- All imagining/scanning related tasks for the Commercial Lending department/Collateral Support into the Commercial Lending Workspace platform then all image quality checks on scanned documents
- Re-assembling of the files
- Any other tasks asked of me by my supervisor
- Ability to operate production scanners
- Heavy daily use with MS Word, MS Excel, MS Outlook
- Work independently with little to no supervision, while being in full compliance and adhering to all US Bank standards and practices
- This was a temporary position, specifically designated for COVID-19 Commercial Lending Services
Records Management Support Administrator II
PGE
- Prepare documents for scanning then accurately indexing scanned documents into computer system
- Perform image quality checks on scanned documents
- Track daily production progress for monthly reporting
- Critical aspect the attention to detail for proper quality checks
- Daily ability to do tedious, repetitive types of tasks
- Heavy daily use with MS Word, MS Excel, MS Outlook, Adobe DC Pro
- Create and distribute PO’s
- In full compliance with the variety of desk guidelines and PGE practices
- Rely on instructions and pre-established guidelines to perform the functions of the job
- Ability to operate production scanners
- Work independently with little to no supervision
Document Admin
- Managed and organized receipt and transmittal of documentation
- Processed customers returned documents with approvals and/or comments to affected departments
- Prepared and analyzed documentation reports and interfaces with internal and external customers to expedite documentation
- Assembled and organized customer facing documentation for final manuals including Instruction, Operation & Maintenance Manuals, Final Data Books, Manufacturing Record Books, and customer-specified manuals.
- Monitored customer document management and submittal requirements
- Order Instructions as required by the Project Manager
- Archived project and document management documentation
Senior Order Qualification Specialist-3
Providence HME
05.2021 - Current
- Make sure that all orders meet their individual insurance requirements to dispense the equipment ordered.
- Submit Prior Authorizations through the correct insurance company.
- Review documents for valid insurance requirements.
- File and process faxes from clinics, hospitals, and insurance companies.
- Create and update processes and orders for special order items.
- Create word documents for requesting additional documentation from clinics.
- Follow up with clinic staff and patients as needed regarding DME setup.
- Provide referral sources to clinical staff and patients as needed when unable to provide DME.
- Meet with coworkers for peer support, feedback, peer training, and evaluation.
- Meet with supervisors and management to review and update training documentation.
- Reviewing processes for alternative options to increase efficiency and fulfillment.
- Handle escalated calls from patients.
- Cover Customer Care phones when needed and any fill in anywhere they ask me to
Education
Paralegal Program - Applied Legal Science
Everest College
01.2009
Skills
- Work under steady pressure with frequent interruptions and a high degree of public contact by phone or in person
- Read, understand, and review documents for accuracy and relevant information Use applicable office terminology, medical terminology, insurance verification portals, forms, documents, and procedures
- Actively looking for ways to help other people
- Maintain a high degree of professionalism and confidentiality
- Well over 20 years of general clerical experience, all years of which included typing, word processing, and other experience generating documents
- I am skilled in communicating orally and in writing with a variety of people answering questions and gathering/exchanging information
- Skilled in organizing work efficiently and exercising independent judgment in making appropriate decisions concerning work methods
- Skilled in working in an automated environment, using computers, scanners and other electronic equipment with ease
- I have used various computer systems/databases such as Citrix, Epic, TIMS v 7, Facets and all Microsoft based programs
- I have been not only a manager but also a Leader/Mentor for many of my colleagues
- Handle escalated calls from patients regularly
Timeline
Senior Order Qualification Specialist-3
Providence HME
05.2021 - Current
Equipment Care Specialist-1 and 2
Commercial Lending/File Management Specialist
US Bank
Records Management Support Administrator II
PGE
Document Admin
Paralegal Program - Applied Legal Science
Everest College