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Quality Assurance Medical

Location:
Birmingham, AL, 35242
Salary:
75000
Posted:
May 09, 2013

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Resume:

Amanda R. Britton

**** ****** ***** 205-***-****

Birmingham, AL 35243 abukyi@r.postjobfree.com

Profile

Responsible, organized team player who is dependable, honest and hard working. Passionate in all aspects of work and life,

enthusiastic, open-minded and a fast learner. Creative, results-oriented skilled supervisor with excellent communication and

motivation skills.

Relevant Work Experience

Customer Support Specialist September 2012 – Present

SuccessEHS

• Provide full support to SuccessEHS clients, including helping customers resolve support issues that are both critical and

non-critical in nature, educating customers on the product and championing critical issues throughout the company

• Serve as the primary client contact during daily phone support, monitor and follow up on client issues through to the

resolution

• Ensure client satisfaction by working through all client issues in a timely and efficient manner.

• Assigned work on special projects including, but not limited to RCM Credit Balance project - correcting patient credit

balances in Receivables and South Carolina Medicaid Change to Requirement project – ensuring all South Carolina

FQHCs are sending claims correctly per the Medicaid Advice effective February 1, 2013.

Patient Care Coordinator October 2011 – August 2012

Medical Services Company (MSC)

• Responded to requests from vendors, claims examiners, patients and nurse case managers to facilitate patient care in a

timely manner.

• Handled high volume work load and ensure data is quickly and accurately entered into our internal system, including

requests to examiners and case notes.

• Fielded both phone queue and direct calls from Claims Examiners, Nurse Case Managers, Vendors and patients

• Worked with workman’s compensation claims examiners to authorize durable medical equipment so as to expedite

patient care

• Delegated tasks to teammates ; Respond to and follow up on emails sent o the dedicated distribution group

• First point-of-contact for a sensitive, high-touch carrier

• Quality Assurance follow up with vendors, physicians, carriers and patients – including assisting injured workers with

any issues or concerns they may have

HPRP Program Specialist July 2009 – June 2011

One Roof (Formerly Metropolitan Birmingham Services for the Homeless)

• Trained all HMIS-HPRP users on HPRP regulations passed on from HUD and the Office of Management and Budget,

assisted grantees with workflow implementation based on these regulations, and subsequently trained all HMIS users on

HMIS and HPRP workflow to ensure they met the reporting guidelines

• Provided ongoing support and information to consumers, agency staff, agency directors, and local funders for five

separate Homeless Prevention and Rapid Re-housing grants

• Monitored and audited input of partner agency data according to program guidelines and established policies and

procedures

• Ran monthly and quarterly Business Objects reports for sub-grantees to ensure the information reported correctly

reflects the activities of the agencies

• Submitted requested reports to partner agencies and funders

• Implemented a credentialing system for each user on our system to ensure the user is adequately trained.

Peer Clinical Reviewer Clinical Assistant September 2008 – July 2009

MedManagement, LLC.

• Communicated with office and hospital staff to discuss any additional information needed to process requests

• Confirmed patient eligibility, benefits and status

• Accepted responsibility for ICD-9/CPT coding and provider selection through accurate editing and analysis

Provider Enrollment Specialist August 2003 – June 2005

Aristoi, Inc.

• Ensured all providers were in compliance with federal and state policies regarding licensure for each carrier

• Assisted in the application process for providers at time of credentialing/re-credentialing

• Maintained provider files of current professional licenses, certifications

• Acted as a liaison between various insurance providers and physicians across the Southeast

• Previous positions include Lockbox Specialist and Payment Processing Specialist: 10-key proficiency and speed were

necessary for this position

Education

Auburn University 1998 – 2002

B.S. in Apparel Merchandising and Business

Skills and Abilities

Excellent communication skills, proficient in Microsoft Office and other computer applications, Ability to multi-task and

prioritize large workloads, highly organized and motivated, various supervisory and training experience, knowledge of CPT

codes and medical terminology, administration of multiple databases and information systems, Typing: 63wpm, 10-key

touch: 8524 ksh, Alpha Numeric Data Entry: 11502 ksh

Professional Memberships

Junior Achievement Leadership Council, Young Professionals of Birmingham member, Auburn Alumni Association, Kappa

Alpha Theta Birmingham Alumni, Alabama Alliance to End Homelessness, Low Income Housing Coalition of Alabama,

Metropolitan Birmingham Services for the Homeless, Southeast Regional HMIS Collaborative, National Human Services Data

Consortium



Contact this candidate