Debra J. Dukes
**** ****** ****** – St. Louis, MO 63114
• Eager to work in a patient focused atmosphere while establishing business needs and successes.
• Dedicated work focused to patient care and timely responses.
• Strong acumen of working independently or in a team setting.
• Dependable healthcare employee with a proven record of accuracy and professionalism.
• Skilled at completing simultaneous multiple tasks in a high pressure, fast paced work environment.
• Strong knowledge of working with the Utilization Management Department for health plan services. Skills
• Dedicated customer care liaison
• Microsoft word and Microsoft Outlook
• Epic Hyperspace
• Excel (minimal)
• Right fax
• Medical terminology
• CPT, ICD 9 (10)
• Milliman Care Guidelines (MCG)
• Strong communication skills
• Prepared Utilization Management updates for clinical and clerical staff.
• Trained new employees in Epic Hyperspace
• Assisted in creating training manual for new employees for capitated and non-capitated plans.
• Worked with HMO nursing staff for the implementation of HMO auto adjudication for internal referrals.
• Certificate for classes in ICD 9, CPT, HCPS and billing
• Medical Assisting Certification – Front/Back Office (Pacific Career College Oxnard, CA). Work History
DuPage Medical Group – Referral Specialist
Downers Grove, IL.
04/1999 – 10/2016
• Worked with Internal Medicine and specialty physician’s offices, to determine if patient met medical criteria by obtaining benefits and pre-certifications from patient’s health plan.
• Worked for capitated (HMO), non-capitated (PPO) departments. Being utilized where needed.
• Scheduling patient appointments with a high call volume. Entering new or existing patient information.
• Knowledge of billing and procedures
• OSHA safety advocate
• Worked as front desk coordinator when needed, high patient volume between 60-120 patients per day. Psychiatric Associates – Referral Coordinator
06/1997 – 04/1999
• Supervisor of referrals
• Acquired benefits and authorizations with patient’s health plan, for number of sessions patients were allowed. Also, number of days for inpatient or outpatient mental health treatment.
• Created physician’s weekly schedules
• Assisted in payroll