Management Specialist Insurance Verification
Resume:
Michelle Allen-Helton
Eubank, Kentucky 42567
adveqp@r.postjobfree.com
Objective
I have 32 + years' experience in the medical field, whether it be clinical, hospital, nursing home, and pharmacology that I would like to continue my experience for the right company.
Experience
April 18, 2022- Present
Utilization Management Specialist
The Adanta Group
Somerset, Kentucky
I work with 6 Medicaid groups which include Aetna Better Health, Athem Blue Cross Blue Shield, Humana, Passport, Traditional, and WellCare. I compile a list and check all information between Kynet and our Electronic Health Records to see if all information is identical, check dates of eligibility, and whether client is following protocols of their therapy. If not, I send provider the information that is found to contact client to continue therapy or close chart.
January 4, 2018- January 5, 2022
Clinical Management
Doctor Clifford C. Matthews Jr.
Somerset, Kentucky
I was responsible for many duties which included secretarial, receptionist, nurse assistant, done prior authorizations for patients and with their insurance companies, refills of medication, calls between our office and hospitals, other clinics, pharmacy and insurance companies, doctors call schedule and personal, and kept track of hospital charge sheets. I also done billing with ICD-10 codes and all forms of insurance.
My knowledge and skills:
CPT coding, ICD-10 codes, Pharmacy technician experience (15 years), Medical terminology, anatomy knowledge, Patient care, Microsoft office, Microsoft Excel, Office Computer skills, Phone etiquette, Several semesters of nursing, lCD-10, management of insurance verification, and medical records, hospital and clinic EHR systems.
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