Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Linda Smith

Manchaca,TX

Summary

Seasoned Utilization Review Specialist with a proven track record at Longhorn Medical, adept in operations development and demonstrating exceptional interpersonal communication. Excelled in ISO9002 auditing, enhancing customer service quality, and leading successful project management initiatives. Managed diverse teams, achieving significant quality improvements and operational efficiencies.

Overview

28
28
years of professional experience
1
1
Certification

Work History

Utilization Review Specialist

Longhorn Medical
Austin, TX
10.2018 - 08.2020
  • Collects and reviews all patient insurance information and submits prior-authorization form. Communicates with the ordering physician's practice for denials that will require appeals and rescheduling.
  • Review and analyze documents for accuracy and compliance. Ensure all documents meet required standards and regulations. Collaborate with different departments to gather necessary information. Identify discrepancies and ensure documents are complete and accurate.

Realtor - Self Employment

Keller Williams
Austin, TX
05.2015 - 06.2018
  • Educate clients on buying, selling and leasing real estate
  • Understand the client desire and to narrow property search to a minimum in order to facilitate a quick close
  • Work with title companies, attorneys, surveyors, and appraisers, inspectors, civil engineers and property owners
  • Reach an amicable solution to move forward to close deal
  • Identify, qualify, and quick close on clients
  • Prospect and develop new business relationships
  • Extensive marketing and thinking out of the box to acquire customers
  • Research on property ownership, zoning land use, egress and ingress on properties and any type of information needed to advise client
  • Advise clients on market conditions, prices, mortgages, legal requirements, mortgage lending and related matters
  • Prepare documents such as representation contracts, purchase agreements, closing statements, deeds and leases
  • Managed three employees

General Clerk II - Medical Claims Processor

Veteran's Administration- contractor
10.2014 - 04.2015
  • Examine vouchers, invoices, claims and other payment requests for medical services for authorized veteran patients
  • Documents must be accurate, provide adequate documentation or citations, and comply with laws and regulations
  • Justification submitted must be in compliance with CPT, HCPCS and ICD-9-CM and ICD-10-CM standards
  • Maintain an understanding of billing and regulations as related to Medicare
  • Must have strong working knowledge of Microsoft Office Suite
  • Proficient with web based applications, have a meticulous attention to detail and process payments for medical claims

Realtor - Self Employment

REMAX
11.2003 - 09.2014
  • Educate clients on buying, selling and leasing real estate
  • Understand the client desire and to narrow property search to a minimum to facilitate a quick close
  • Work with title companies, attorneys, surveyors, and appraisers, inspectors and property owners
  • Reach an amicable solution to move forward to a close deal
  • Identify, qualify, and quick close on clients
  • Prospect and develop new business relationships
  • Extensive marketing and thinking out of the box to acquire customers
  • Advise clients on market conditions, prices, mortgages, legal requirements, mortgage lending and related matters
  • Prepare legal documents such as representation contracts, purchase agreements, closing statements, deeds and leases
  • Managed five employees

Medical Assistant

Texas Medclinic
New Braunfels, TX
05.2013 - 08.2013
  • Drug testing, process rapid mono tests, strep tests, pregnancy test, collect patient history, vitals, wound care, give injections for medication, give injections for immunizations, tb tests, apply splints and casts, educate patients how to use crutches, patient customer service, prepare patient rooms, process blood samples for doctor, autoclave tools, handle supplies and keep office stocked, vitals, EKG's, orthostatics and phlebotomy
  • Use EMR
  • BLS-CPR, First Aid
  • Nextgen billing and white board charting, testing for drugs, alcohol and testing of PPE equipment (respiratory masks), conducted auditory testing and distance visual acuity
  • My externship was completed with Texas Med-Clinic

CNA

Corrine Riviello
Buda, TX
06.2010 - 06.2013
  • Home Healthcare, hospice care, ADL's, CPR certified, feeding, toileting, bathing, home care, laundry
  • Assist the client to improve their quality of life to the best of their ability
  • Establish a relationship so they feel cared for and not feel alone or scared
  • Read to them and tell stories that make the client happy
  • The goal is happiness

Patient Care Technician III

St. David's Medical Center
12.2008 - 05.2010
  • Meditech charting, patient care, phlebotomy, catherization, vitals, CPR certified, accuchecks
  • Help the patients stay in the hospital be as comfortable as possible
  • Cheering them up and bringing encouragement to them

Land Acquisition Agent - Right of Way Agent

City of Austin Public Works Department- Contractor
Austin
05.2007 - 04.2008
  • Acquire real estate from property owners to complete bond programs, improvement programs for the City of Austin, negotiating contracts, prepare correct legal contracts, work with attorneys, title companies, file legal acquisitions and always maintain professional courtesy to the landowner you are negotiating with
  • Explain the pros vs
  • The cons for homeowner's or landowner's to be satisfied with the project, within the confines of the project, and property returned to original look or improved
  • Prepare presentations for landowner's to understand 'eminent domain' and what their rights are
  • Research on property ownership, zoning land use, egress and ingress on properties and any type of information needed to negotiate the taking of land for project
  • Setup appraiser appointments and facilitate meetings with project manager through negotiations and completion of project
  • Must understand and know the project intimately in order to negotiate deal with landowner and to accomplish the needs for project manager
  • Work as a team with civil engineer to obtain property needed to go forward with project
  • Negotiate effectively to facilitate quick close

Quality Customer Operations Service Manager

Cirrus Logic
10.1993 - 07.2002
  • Guarantee the integrity of software
  • Manage document control
  • Also, ensure Customer relations are handled effectively and expediently for end of life products and product enhancement's
  • Prepared company to become ISO9002 certified and audit company to maintain ISO9002 certification
  • Audit 3rd party vendors, issue corrective actions, monitor corrective actions and ensure closure of these corrections
  • Distribute and balance workload for staff
  • Set timeframes for completions of such work and ensure employees are continually being productive
  • Train staff and have written job descriptions and written procedures for job expected to be completed
  • Employee resolution of concerns or complaints including counseling, if necessary with employees
  • Manage and maintain annual budget
  • Managed twelve employees
  • Travel 50%

EHS Administrative Assistant

AMD
09.1992 - 09.1993
  • Belong to First Response Team for any health related problems and respond to spills or accidents, write reports including why accident happened and explanation for safety, environmental or health hazard
  • Complete action item to correct the problem from happening again
  • Follow up on action
  • Maintain fire extinguishers effective dates
  • Search campus for any problems that must be taken care of
  • Handle corrective action items from creation, monitoring and completion

Education

Nursing - Sociology

Texas State University
01.2013

Medical Assistant and Nursing Assistant -

Austin Community College
01.2012

Real Estate Classes -

Austin Community College
01.2002

Skills

  • Operations Development
  • Effective project management
  • Microsoft Office Proficiency
  • ISO9002 Auditing expertise
  • Employee Management Skills
  • Excellent Customer Service
  • Utilization management
  • Quality improvement
  • Interpersonal and written communication
  • Utilization review

Certification

  • Certified Nurse Assistant, 2007
  • CPR, 2007 - Present
  • First Aid, 2012
  • Medical Assistant, 2012
  • Real Estate License, 2003
  • IRW - Right of Way, 2008
  • Title Searching, 2014

Timeline

Utilization Review Specialist

Longhorn Medical
10.2018 - 08.2020

Realtor - Self Employment

Keller Williams
05.2015 - 06.2018

General Clerk II - Medical Claims Processor

Veteran's Administration- contractor
10.2014 - 04.2015

Medical Assistant

Texas Medclinic
05.2013 - 08.2013

CNA

Corrine Riviello
06.2010 - 06.2013

Patient Care Technician III

St. David's Medical Center
12.2008 - 05.2010

Land Acquisition Agent - Right of Way Agent

City of Austin Public Works Department- Contractor
05.2007 - 04.2008

Realtor - Self Employment

REMAX
11.2003 - 09.2014

Quality Customer Operations Service Manager

Cirrus Logic
10.1993 - 07.2002

EHS Administrative Assistant

AMD
09.1992 - 09.1993

Nursing - Sociology

Texas State University

Medical Assistant and Nursing Assistant -

Austin Community College

Real Estate Classes -

Austin Community College

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Linda Smith