Pemi Benson
Brockton, MA,MA
Summary
An energetic and enthusiastic professional who is motivated to succeed in a fast paced professional environment. My goal is to obtain a challenge full time position with the opportunity for future advancement, and also obtain a position that will enable me to use my strong organizational skills and educational background.
Overview
13
13
years of professional experience
Work History
Managed Care Coordinator
Beth Israel Medical Center
Boston, MA
07.2020 - Current
- Initiate and review authorization requests for DME, transportation, inpatient, and outpatient members
- Provide review and analysis of post-service for both outpatient and inpatient medical claims
- Use guidelines and review tools to analyze assigned claims and medical records to either summarize or approve
- Review faxed authorization request to input into the system
- Perform reconsideration review of denied claims
- Collaborate with the Appeals department to provide all related information to overturn denials
- Promptly respond to general inquiries from management, staff, providers and patients via email and fax
- Answer incoming calls from providers assisting with the appeal process and resolve billing questions
- Code each diagnosis of service using ICD-10 and procedure codes according to standards
- Input referral and Prior Authorizations into the system
- Referring them to the appropriate when necessary
- Responsible for intake, data entry, and research to determine
- Precertification status for several insurance companies
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Trained staff, providing direct supervision, ongoing staff development and continuing education to employees.
Administrative Assistant II
Beth Israel Medical Center
Boston, MA
05.2018 - 08.2020
- Executed record filing system to improve document organization and management.
- Answers and screens telephone calls. Takes accurate messages or directs call to appropriate person. Greets and directs patients/families, visitors and staff.
- Responds to requests in a timely manner and provides clear and accurate information within scope of knowledge and authority. Types correspondence, forms, reports, manuscripts or other materials that may require complex formatting.
- Prepares documents with stylized formats, lettering or graphics using specialized commercial software, such as desktop publishing or graphics packages. Proofreads and edits materials for grammar, punctuation and spelling.
- Schedules appointments and meetings and maintains personal calendars for manager/director(s). Organizes conference calls and meetings, sometimes with large numbers of participants. Reserves meeting locations and equipment.
- Prepares meeting agenda and other materials. Prepares travel arrangements as needed. Organizes and schedules conferences, seminars or other department sponsored programs or events.
- Coordinates all necessary arrangements: location, registration forms and fees, agenda, refreshments, materials and equipment.
- Maintains departmental files, records and databases. Enters information from source documents into computer databases and/or spreadsheets, compiling, printing and distributing periodic reports, mailing labels and other information as needed. Maintains department reference library of books, journals and other materials.
Assistant Manager
African/American Market
Boston, MA
04.2015 - 07.2018
- Provided exceptional support to clients and managers
- Resolved client issues and made sure clients’ expectations were met
- Managed the bookkeeping and accounts payables/ receivables
- Created inventory and orders using ERP and Oracle
- Introduced a user-friendly electronic filing system that reduced file retrieval time
- Made checks out to employees and paid invoice bills for different vendors
- Managed data using a computerized maintenance management system
- LANGUAGES
- English – Written and Verbal Yoruba (Nigerian)
Staffing Manager
One
Boston, MA
09.2012 - 06.2018
- Determined staffing needs and schedule staff for optimal patient coverage
- Monitor shift duties and performance; develop assignments, ensuring accurate and efficient patient care
- Complete and submit pay roll
- Intervene in patient care as necessary to prevent complications or improve outcomes
- Managed applicant tracking system (ATS) database by entering, updating and maintaining candidate contact details, resumes and supporting documentation
- Developed and facilitated all new-hire orientations
- Developed guidelines, questionnaires and processes for assessing, interviewing and onboarding phases
- Improved office efficiency by effectively managing internal communications and correspondence
- Assisted senior management with making key decisions by developing and submitting performance and compensation reports with status updates and improvement recommendations
- Directed full background check process (Including: detailed references, drug testing, education verifications, bond ability, credit checks and criminal reports).
Education
Bachelor of Science - Health Care Management
Cambridge College
Associates - Social Science
Bunker Hill Community College
Skills
- Strong organizational skills along with the ability to prioritize multiple tasks simultaneously
- Familiar with medical terminology, medical and insurance legislation as well as proficiency in handling various office tools
- Basic computer and typing skills, including proficiency with MS Word, Excel, Power Point, and Outlook
- Excellent customer-service skills along with the ability to interact in a very courteous, and professional manner with patients and visitors
- Exceptional team-working skills to maintain effective working relations with the healthcare and administrative staff
- Strong time management skills along with ability to handle pressure, and work under tight deadlines
- Ability to analyze and solve various staffing or patient issues quickly as well as prepare financial statements and budgets
- Ability to exercise tact, discretion, and good judgment while dealing with confidential matters
- Excellent reporting and administrative writing skills along with the ability to
- Maintain accurate medical records or patients' file
- Obtain precertification status for several insurance companies
- Initiate and review authorization requests for procedures, inpatient, and outpatient members
- SKILLS
- EPIC
- Oracle JDE System
- Microsoft Suite
- Outlook
- Data Management
- Data Analysis
- Proficient in MS Excel, Word, PowerPoint
- Proficient in SQL
- Data gathering and analysis
- Data Manipulation
- Machine learning
- Interdepartmental collaboration
Timeline
Managed Care Coordinator
Beth Israel Medical Center
07.2020 - Current
Administrative Assistant II
Beth Israel Medical Center
05.2018 - 08.2020
Assistant Manager
African/American Market
04.2015 - 07.2018
Staffing Manager
One
09.2012 - 06.2018
Bachelor of Science - Health Care Management
Cambridge College
Associates - Social Science
Bunker Hill Community College