Teasia Smith
Suffolk,VA
Summary
Experienced Utilization Management Representative with a background in managing patient case reviews and ensuring adherence to healthcare policies. Strengths include strong analytical skills, ability to interpret medical records and make informed decisions based on findings. Proven track record of streamlining workflow processes, fostering patient satisfaction, and upholding compliance standards in previous roles.
Overview
9
9
years of professional experience
Work History
Utilization Management Representative
Elevance
Norfolk, Virginia
12.2021 - Current
- Collaborated with healthcare providers to clarify treatment plans and secure timely authorizations.
- Reviewed clinical documentation to verify compliance with policies and regulations, enhancing accuracy of patient care.
- Communicated clinical decisions to physicians and other healthcare professionals, ensuring alignment on treatment protocols.
Medical Receptionist Supervisor
Right Path Treatment Center
Virginia Beach, Virginia
08.2017 - 11.2021
- Managed staff schedules and delegated tasks to optimize workflow efficiency, enhancing overall office operations.
- Trained new receptionists on patient management software and office protocols, promoting operational consistency and reducing onboarding time.
- Maintained confidentiality of patient records in strict adherence to regulations, safeguarding patient trust and compliance.
Education
High School Diploma -
Nansemond River High School
Suffolk, VA06-2013
Some College (No Degree) - Medical Technology
Tidewater Community College
Norfolk, VASkills
- Treatment authorization
- Clinical documentation and regulatory compliance
- Healthcare communication
- Patient management software
- Workflow optimization
Timeline
Utilization Management Representative
Elevance
12.2021 - Current
Medical Receptionist Supervisor
Right Path Treatment Center
08.2017 - 11.2021
High School Diploma -
Nansemond River High School
Some College (No Degree) - Medical Technology
Tidewater Community College