Rahmatullah Shyllon
Kinston,NC
Summary
To apply my professional experience and educational background to ensure the success and achievement of a Healthcare organization's goals and objectives.
Overview
22
22
years of professional experience
Work History
Clinical Intake Coordinator
Blue Cross Blue Shield of Massachusetts
Hingham Remote , MA
02.2023 - Current
- Proficiency in knowledge of Blue Cross Blue Shield products to both inform and direct physicians through appropriate guidelines and processes.
- Ensured compliance with HIPAA regulations and other relevant laws related to patient privacy.
- Remaining in compliance with Federal Employee guidelines.
- FEP and FEP SNF case processing, inbound call support
- Build and maintain Commercial cases and authorizations for healthcare facilities and physicians.
- Analyze and apply Blue Cross plan requirements and clinical guidelines in making sound and objective decisions in client case-related matters.
- Articulate complex concepts, both verbally and in written form, to clientele.
- Demonstrate patience and empathy with both internal and external clients.
- Handle clients tactfully, courteously, and professionally.
- Demonstrate a commitment to quality performance and a professional demeanor.
- Exceed departmental established key performance guidelines.
- Critical thinking and analyzing information in order to construct effective solutions.
Virus Testing Administrator
Healthcare IT Leaders
Taunton, MA
11.2021 - 06.2022
- Administered required COVID-19 rapid tests and collected specimens using proper swabbing technique.
- Maintained cleanliness of testing booth and testing materials to comply with CDC guidelines.
- Followed in-process quality control procedures and performed accurate data entry of patient information to prepare collected specimens for testing and analysis.
- Reminded individuals to follow proper social distancing and comply with mask mandates.
- Explained reason for testing and process involved to each client.
- Documented data in designated system to present to client upon request.
Processing Rep/ Lap Rep Tuberculosis Lab
Quest Diagnostics- Oxford Immunotec
Norwood, MA
11.2017 - 01.2020
- Coordinated the receiving of specimens
- Accounting for patient specimens
- Entered patients demographics and test orders
- Perform service acquisitioning with in the requistioning test processing stage
- Dispensed Ficoll into Leucosep test tubing in preparation for TB testing
- Loaded and unloaded refrigerated centrifuge
- Prepped test sample set ups, labeling and scanning
- Quality control checks and daily reporting
Client Relations Operations Sp of Federal Appeals
MCMC LLC
Quincy, MA
06.2011 - 11.2017
- Responsible for quality assurance of clinical reviewed cases by physician consultants
- Reviewed case documentation with clients, physicians and nursing staff
- Ensured provider requirements were met before returning decision to client
- Identified and reported quality issues
- Acted as a liaison between physicians, clients, and account managers
- Acted as a liaison between nurses and physicians in communicating case decisions, which determined medical necessity or otherwise to the client/patient
Customer Care Rep/Accounting Admin. Assistant
Whittier Street Health Center
Boston, MA
09.2003 - 09.2013
- Independently operated the dental dept. customer service desk
- Processed provider's appointments.
- Performed operational duties by opening and closing the dental dept.
- Accounting Administrative Assistant duties included:
- Bank Reconciliations
- Bank Deposits
- Daily Accounting processing
- Payroll
- Journal entries
- AP and AR
- Supervising interns and training
Education
Associate of Arts - Health Care Management
Lenoir Community College
Kinston, NC06-2026
Skills
- Microsoft Office, Outlook
- FEP Direct
- MHK, RTMS, OLB
- Healthcare compliance
- Effective communication
- Critical thinking
- Client relations
- Attention to detail
- Customer service
- Conflict resolution
Affiliations
Best of Whittier Award
Representation and Administrative support to the Finance, Productivity, Rick Management, Ethics, JCAHO Accreditation and Safety Committee's
Timeline
Clinical Intake Coordinator
Blue Cross Blue Shield of Massachusetts
02.2023 - Current
Virus Testing Administrator
Healthcare IT Leaders
11.2021 - 06.2022
Processing Rep/ Lap Rep Tuberculosis Lab
Quest Diagnostics- Oxford Immunotec
11.2017 - 01.2020
Client Relations Operations Sp of Federal Appeals
MCMC LLC
06.2011 - 11.2017
Customer Care Rep/Accounting Admin. Assistant
Whittier Street Health Center
09.2003 - 09.2013
Associate of Arts - Health Care Management
Lenoir Community College
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