Medical Mental Health

Debra J. Dukes

Phone: 314-***-****

Email: ********@*****.***

**** ****** ****** – St. Louis, MO 63114

Summary

• 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

Accomplishments

• 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

Naperville, IL.

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

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