DIANA M. DURAN
To continue to broaden my knowledge in the Medical Field and continue to succeed in a great and honorable organization. Learning is a privilege I want to continue experience. Skills
Word, Excel, and PowerPoint. WPM 90 +. ICD 10, CPT Coding Training Certified IV and Blood Draw
ICD 10, Immunology, Radiology, Sales
Experience, scheduling surgeries
Account Development Specialist
As an Account Development Specialist in a Functional Immunology and Autoimmunity company, I am the liaison to new account holders.
I manage new account holders by introducing them to the company and the services we provide. I guide providers through the account and explain the tools they need to submit their orders for testing their patients.
I provide over the phone orientations where I point out key aspects of the account and offer assistance when submitting orders.
Marketing and Branding for our unique testing for autoimmunity and immunology. I am also the Account Representative for our International Accounts in the U.K. and Ireland and the US Territory of Puerto Rico.
Case Management/ CCIP/ QIP/ UM Coordinator
Citizens Choice Health Plan HMO - Alignment Healthcare Managed and Delegated my own patients of 100+ and referred to appropriate follow up care. As the lone Case Management Coordinator, I was pulled into assisting our UM Depart in processing authorization requests and/or help in the Incoming Call Queue Knowledgeable of EZ-CAP and Access Express.
Entered Admitting Face Sheets when the load is increasing. Managed and processed IPA/MG's monthly bed-day reports. I was a back-up for the Credentialing Department.
Member Services- Provide services over the phone to members with concerns and/or questions regarding their coverage.
Utilization Management Coordinator
Little Company of Mary Hospital
Began experience as an Administrator Coordinator, then was pulled into assisting our UM Depart in processing Emergent, Urgent authorization requests and/or help in the Incoming Call Queue. Knowledgeable of EZ-CAP and Access Express.
Managed Office Visit sheets and correct ICD-9 codes for appropriate billing. Administrative Assistant/ O.R. Scheduler
Urgent/Emergent Referrals Coordinator
I ensured all urgent and Emergent/Stat referrals were submitted in a timely manner and assisted in scheduling patient's first initial appointment for the procedure/visit requested by PCP using Access Express.
My position as a Customer Relations Representative required me to answer incoming calls and to schedule service appointments.
We were also are in charge of making follow-up calls for surveys. Case Management Coordinator
C: 949-***-**** email@example.com
St. Mary Medical Center
I am expected to complete any tasks delegated from the nurses for members improvement in their health. From, medical records request, archive and link documents, to making out bound recruitment calls. Coordinators also mail and provide members with Educational Material. I am also in charge of the more controlled and compliant diabetic members which I outreached to every 3 months and monitor labs monthly to determine if they need to be directly under the supervision of a CM Nurse.
I also make sure, PCP/Specialist appointments for members are made and outreach to IPA/MG's for authorization processes.
Quality Improvement Program- This is a time sensitive program to avoid re-admission within 30-days. Due to my medical knowledge I am allowed to perform moderate assessments on the members that I reach out to for our re-admit program and provide guidance with medications and nutrition. I can also make a determination if a particular member needs immediate attention from a nurse., as an Administrator and surgery scheduler.
As an administrator I dealt with the clerical side of admitting patients before and after their procedures. I also scheduled surgeries for the Main O.R.
and the Surgical Center.
From, Sept 2010-Feb 2011, I worked in the Admitting, Radiology and ER Admitting. Education and Training
Medical Allied Graduated:
Pending State Exam Cal State Long Beach.
Norwalk High School