Quality Assurance Medical
Resume:
Shelli Ray
Atoka, Tn. *****
abld2f@r.postjobfree.com
Education
Elliston Baptist Academy
Elliston Road
Memphis, Tn.
Graduated with Major in Business and Music
Board Certified X-ray Technician
Limited Certification in Core, Chest and Extremities
Professional Experience
Sedgwick Claims Management
2620 Thousand Oaks Blvd.
Memphis, Tn. 38118
March 2003 - Present
When starting at Sedgwick, my title was CSR I, this involved taking Workman
Compensation claims, General Liability, Auto Liability, FMLA and Short Term
Disability claims from numerous clients. After being with the company for 1
year, I was promoted to a Quality Assurance Representative, this involved
proof reading claims and making corrections before the claims were sent to
the claims examiners. A Quality Management group was developed 2 years
later and this was an added responsibility to the Quality Assurance Rep.
With quality management, you not only continued to proof read claims, but
also had the ability to monitor calls in real time, after completion, by
phone and video. Once completed a feedback session was required with the
CSR that had completed the claim to give suggestions and information on how
to make the intake process a more pleasant experience for the client, as
well as, reduce the number of errors per claim.
Committees served on: Call Center Activity Committee - 5 years
Round Table Committee - 3 years
Committee to Rewrite Policy and
Procedure Manuel - 1 year
Robert Kline, MD
6005 Park Ave.
Memphis, Tn. 38120
January 1988 - October 2002
This single practice physician office consisted of 2 medical assistants and
1 front office assistant. Primary responsibilities were to perform basic
medical duties. These duties included, but were not limited to, checking in
patients, take and recording vital signs, order all needed medical
supplies, obtain and properly handle specimens, clean and stock exam rooms,
clean and sterilize instruments, clean and check equipment for proper
functioning, clean and stock medication sample closet. Other duties were to
assist the physician with procedures such as Colposcopies, Lasers,
Endometrial Biopsies, Ultrasounds, etc. and administer injections as
directed by the physician. Also included was scheduling office, hospital
and/or follow-up procedures, triage patient calls, call in prescriptions,
perform general lab duties, to include venipuncture, injections, microscopy
preparations and preparing specimens for outside labs.
Front office duties were to help cover front desk area, answer phones, file
charts, write and file lab work in charts, make appoints and reminder
appointment calls to patients, make a deposit daily and take to the bank.
Business office duties were to enter patient and hospital charges into
computer, file insurances, fill out all Short Term Disability, FMLA and
other forms for patients, verify coverage's, percentages and co-payment
amounts and pre-certify hospital stays and surgeries. At the end of each
month, totals had to be ran, bills printed, mailed and collection accounts
worked.
I also attended yearly ICD9 and CPT coding classes to keep current on HIPPA
laws and the constantly changing coding, as well as, Medicare, Medicaid and
Tenncare Conferences yearly.
Methodist Minor Medical Center (part-time)
8071 Winchester Road
Memphis, Tn. 38120
October 1996 - March 1999
While working in this urgent care setting, I received a Limited x-ray
certification, BAT certification and worked as the lab technician. I also
assisted the physician in the exam rooms, took vital signs, administered
injections, took drug screens and any other clinical duties needed to help
the physician, resident physician or nurse.
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