
Medical management specialist with over 6 years of experience in the healthcare sector. Proficient in data entry, software testing, and telephone etiquette. Strong oral and written communication skills enhance team collaboration and client interactions.
● Gathered clinical information to determine appropriate referrals for cases, streamlining the process for utilization and case management.
● Conducted utilization management review activities that required interpretation of clinical information.
● Provided assistance with managing complex patient cases in collaboration with the medical team.
● Supported Medical Management and Operations by coordinating nonclinical tasks to enhance workflow.
● Maintained accuracy and security of medical records, ensuring compliance and confidentiality in case handling.
● Input data into computer systems while maintaining security and accuracy of medical records.
● Prepares reports and documents all actions.
● May act as liaison between Medical Management and/or Operations and internal departments.
● Improved patient satisfaction scores by addressing concerns promptly and providing personalized attention.
● Communicated effectively with staff, patients, and insurance companies by email and telephone.