PETA-GAY BOWMAN
Cupertino,CA
Summary
Experienced professional with demonstrated history of working in the healthcare industry and public health. Proven ability to facilitate communication between medical facilities, the providers and sometimes the members. Responsible for ensuring that medical services are authorized and that regulatory guidelines are followed. Skilled with Medicaid services, Epic and possessed strong interpersonal and communication skills to effectively perform administrative activities. Skilled multitasker with superior work ethic and good teamwork, problem-solving and organizational skills. Willing to take on any task to help team. Reliable and dedicated team player with hardworking and resourceful approach.
Overview
14
14
years of professional experience
Work History
Patient Admin Specialist IV
Stanford Healthcare
05.2019 - Current
- Provide doctor-patient support using reference documents and tools
- Consistently manage daily productivity goal of 50 or more
- Expert level knowledge of EPIC or another patient database
- Possess ability to foster relationships, build trust with providers, nurses, staff and patients to work in collegial team environment and stressful interactions
- Expert level communication, customer service, interpersonal skills and cross-cultural competency
- Meet/Exceed organizational and department service standards
- Developed strong patient relationships through consistent communication and attentive service.
Managed Care Coordinator
Horizon BCBSNJ
09.2013 - 12.2018
- Performed review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians
- Handled initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under oversight of clinical staff
- Prepared, document and routes cases in appropriate system for clinical review
- Upon collection of clinical and non-clinical information, MCC can authorize services based upon scripts
- Reviewed professional medical/claim policy related issues or claims in pending status
- Upon completion of inquires, initiated call back or correspondence to Physicians to coordinate/clarify case completion
- Telecommute; Worked remotely from home for last 3 years.
Per-diem Community Education and Outreach Assistant
Princeton Healthcare System
09.2013 - 08.2016
- Served in Community Outreach Department
- Assisted with phone calls and customer service oriented
- Coordinated event planning such as seminars and hospital tours
Intern
Planned Parenthood Association of the Mercer Area
01.2010 - 05.2010
- Contributed to positive team environment by collaborating with fellow interns on group projects and presentations.
- Supported staff members in their daily tasks, reducing workload burden and allowing for increased focus on higher-priority assignments.
- Enhanced intern productivity by assisting with project coordination and providing ongoing support.
Skills
- Proficient in Epic, MS Word, and Access,
- Fast adapter/Learner
- Self-Driven and Ambitious
- Developed Healthcare Communicator
- Agile leader,
Skills:
- Cross functional collaborationist
- Traveling and Major Foodie
- Sports mom
- Food Bank Volunteering
Interest:
Education
Bachelor of Science in Public Health -
Rutgers University
New Brunswick, NJ05.2010
Timeline
Patient Admin Specialist IV
Stanford Healthcare
05.2019 - Current
Managed Care Coordinator
Horizon BCBSNJ
09.2013 - 12.2018
Per-diem Community Education and Outreach Assistant
Princeton Healthcare System
09.2013 - 08.2016
Intern
Planned Parenthood Association of the Mercer Area
01.2010 - 05.2010
Bachelor of Science in Public Health -
Rutgers University
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