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Medical Claims/Behaviorist/Claims Speacilist/Counselor/Auditor

Location:
Los Angeles, California, United States
Salary:
50k/Open
Posted:
August 10, 2018

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Resume:

Lola Shannon

P.O. Box *****

Los Angeles, California, 90009

Cell: {424} 832-6772

E-mail: ac6mlk@r.postjobfree.com

I am seeking employment with a thriving and successful goal-oriented company with growth and stability.

DEGREE and CERTIFICATION

• Master of Science in Psychology – University of Phoenix

• Medical Records – Charles Drew University/Hubert Humpy Medical Center

• City of Los Angeles Vita Program Tax Preparer Certificate

PROFESSIONAL EXPERIENCES

JOHN M. STALBERG, M.D., J.D., - STATE OF CALIFORNIA FORENSIC PSYCHIATRIST

Intern Psychology Student

• Assistant in historian evaluation, admit patients written reports, and counseling. Analyzed information regarding overall evaluation, office/reception duties as needed, high-profile calls regarding patient data, prepared reports related to client case, and counsel patients in a healthcare environment. Progress notes for patient statistical data and treatment, and monitor patient schedule.

• Participate in mental health interviewing of patient relationship/emotions, and personality traits that have the bearing on the patient's illness, treatment, recovery and summary reports.

Intensive Behavior Intervention Consultants, LLC (IBIC)

Behavioral Therapist January 2016-Present

Behavior intervention service for disability students within a school/home setting. Career-minded, confident, assertive in engaging with passion for helping children. Display a professional and safe demeanor with exceptional decrement and judgement skills at all time. Based on implementation evidence of ABA program treatment designed specifically for school/home setting.

Ensure program integrity implementation by incorporating the behavior plan, reinforcements, promptings and utilizing scripts as required, providing the daily documentation, and collecting accurate data.

Provide accurate feedback and continuing documentation required deadline.

Attend and complete all mandatory trainings.

Exercise professionalism, discretion and confidentiality pertaining to the aspect of all work environment.

Professional demeanor with exceptional interpersonal skills.

Ability to work in a culturally, economically, ethnically, linguistically diverse populations.

KELLY SERVIC – Temporary Services

Health Net/Ceridian Capital/Claims Exmaner Spicialist/Medical Claims January 2013-December 2015

Professional office environment, quality assurance with HEDIS, customer service skills, multi-task in a fast pace environment, communication skills, and front office services. MS Office, licensing operation and interpersonal skills, liaison with staff/victors, input information into excel spreadsheets, incoming enquiries, friendly, and team player. Computerized fax/mail delivery, verification/authorization on tracking coordination system, HER, communication skills/oral/written, data quality assurance, policy and procedures, NCPI, problem-solving, documentation, electric health record and professional phone calls.

Detail orientated, database access of data internally, typing and filing in/out-going correspondence, data entry, office inventory, and staff support. Understanding of product for health plan, accurate, knowledge of methodology contracting claims reimbursement and pricing strategy. Knowledge of Microsoft Word/Excel, work with Certificates, Diploma program, online program and problem behavior interion.

Ceridian: Research data for input/output operation for payroll reports, client payments for the year-end and monthly cycle, charts, and financial updates. Skilled in professional problem solving, computerized data entry, data monitoring, formal data, ten key, medical analysis, provided client and customer with accurate updates, team player, and time management.

AEROTEK

Blue Shield – Medical Reviewer January 2015-June 2015

HEDIS off-season Audit and Quality Assurance, office services, contact HEDIS internal auditor with questions for interpretation specifications. Data entry, physician and client calls. Supervised and trained employees for company positions. Skilled in maintaining confidentiality information and all policy and procedure for quality assurance.

LOS ANGELES COUNTY

In Home Social Services (DPSS)

Provide senior and child care services in the home, counsel clients, meals, and marketing. Supervised a team of employee's, socialization skills for teens and young adults, home improvement, and senior/child care eligibility reports, scheduled/confirmed appointments, case management reports and electronic medical records.

PARAMOUNT UNIFIED SCHOOL DISTRICT

Administrative Assistant

Performed administrative duties, home visits for case studies leadership skills that required flexibility and understanding student's strengths and weaknesses. Customer services in a school office setting, worked in a demanding environment with children of various backgrounds, record data entry.

Prepared and maintained student records regarding operations, tracking student records and courses, everyday student contact, payroll, cashier/finance, invoicing, and front desk operations.

Interfaced with students/parents, managed schedules and conferences. Supervised small staff in district area. Composed correspondence, maintained files/logs, inventory, record office supplies, and receipt payments. Served as administrative liaison within the district. Microsoft Office, Internet and Computer Database.

QUALITY IMAGINE August-2002-September 2007

Medical Assistant: Medical Transcriber/Font Office (Radiology/Urgent Care)

Front Office operations, counseled patients for scheduled appointments, confirm patient purpose for the visit. Performed and assembled cases to ensure a timeline/deadline, schedule staff hours, registration, and customer service.

Prepared carts ad assist physician with patient care. Verified appointments for patient eligibility and insurance authorization. Interviewed patients for information verification, medical history, interact with physicians, patients, and families to provide excellent care services.

TOM BRADLEY COMMUNITY CENTER

Community Services

Eligibility worker, counsel children/teen, and young adult interact effectively with children/family and individuals in a process of public assistance program evaluations. Mad community calls for Development Housing Department (City of Los Angeles). Prepared and maintain eligibility records, data eligibility for new/old clients, and reports.

Counsel individuals who are receiving public assistance within eligibility guidelines for scheduled reports. Social work evaluations were necessary for documentation modification for benefits continuation. Tax preparer for the City of Los Angeles Vita Program (IRS- City of Los Angeles) Integrated Service Information System (ISIS Program).

Work in a multicultural public environment, interviewed applicants for public assistance, financial determination, and continuing eligibility. Explained provision of various public assistance programs, legal rights, and responsibilities. Family Source System Progras and Food Banks. Political office volunteer.



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