Mieshka McKenzie
Montego Bay,Jamaica
Summary
Professional in healthcare management, equipped with strong background in coordinating and optimizing patient care. Skilled in conducting thorough reviews of medical records and collaborating with healthcare teams to ensure compliance with standards. Highly adaptable, reliable, and focused on achieving measurable outcomes. Proven ability to navigate complex healthcare systems and support continuous improvement initiatives.
Driven Utilization Review Specialist with solid background in utilization review. Adept at evaluating patient care plans and ensuring compliance with healthcare regulations. Demonstrated ability in streamlining processes and fostering collaboration to enhance service delivery.
Overview
12
12
years of professional experience
Work History
Utilization Review Specialist
Panacea Healthcare Services
10.2021 - Current
- Responsible for ensuring the necessity and appropriateness of care,
- Effective benefit management and coordination
- Positive communications and relationship.
- In-depth knowledge of healthcare policies and regulations.
- Strong analytical skills for reviewing medical records and treatment plans.
- Effective communication skills for collaborating with healthcare providers and insurers
Utilization Review Specialist
Itel Bpo Solutions
01.2017 - 04.2019
- Obtain prior authorizations for services as required by insurance companies and other payers.
- Monitor authorization periods and ensure timely renewals.
- Maintain accurate and detailed records of reviews, decisions, and communications.
- Prepare and submit required reports to management, payers, and regulatory agencies.
Customer Service/Sales Agent
Elephant/Centerfield
01.2013 - 12.2016
- Provide prompt and efficient responses to customer questions via phone, email, social media, and chat
- Address and resolve customer complaints or concerns in a professional and timely manner
- Maintain a high level of company product knowledge to effectively answer customer queries
- Identify opportunities to upsell or cross-sell products and services to customers
- Collaborate with other team members and departments to ensure customer satisfaction
- Continuously strive to improve customer service skills and knowledge through training programs
Education
Diploma - Business Studies
Marymount Business School
01.2005
High School -
Marymount High School
01.2003
All Age School -
Bromley All Age School
01.1998
Skills
- Email Management
- Healthcare regulations
- Discharge Planning Coordination
- Medicare compliance
- Knowledge of software
- Ability to conceptualize
- Clinical Assessment
- Ability to complete assignments on time
- Utilization management
- Quality improvement
- HIPAA compliance
Personal Information
- Date of Birth: 09/01/86
- Nationality: Jamaican
- Marital Status: Single
References
- Mr. Ranique Lynch, Escalations Manager, Vistaprint Jamaica, 876-883-2621
- Ms. Delpha Frater, Teacher, Marymount Business School, 876-724-2275
Hobbies and Interests
- Meeting dynamic people
- Having meaningful conversations
- Web design
- Marketing
- Sales
Activities
- Key Club, 08/01/97 - 05/31/98
- School Choir, 08/01/02 - 05/31/03
- High School Prefect, 2003
- Student Councilor and Secretary, 08/01/04 - 05/31/05
Languages
English
Full Professional
Timeline
Utilization Review Specialist
Panacea Healthcare Services
10.2021 - Current
Utilization Review Specialist
Itel Bpo Solutions
01.2017 - 04.2019
Customer Service/Sales Agent
Elephant/Centerfield
01.2013 - 12.2016
High School -
Marymount High School
All Age School -
Bromley All Age School
Diploma - Business Studies
Marymount Business School
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