Experienced Utilization Review Coordinator and Secretary seeking employment in a medical or non-medical environment as an Administrative Assistant or Secretary. I am an experienced medical liaison between doctor/patient and insurance company for patients seeking approval of medical treatment plan. I can contribute positively to your company needs and growth.
Knowledgeable of all current and previous medical codes
Skilled in using ICD-10 and ICD-9 as well as CPT coding
Knowledgeable in medical terminology
Experienced in referral and precertification
Skilled in all Windows based applications as well as One Team, SIR, and Juris
Skilled Administrative Assistant, Secretary, and Customer Service
Excellent problem solver with great communication skills
Trained and skilled Utilization Review Coordinator for 18 years. My job was to obtain all medical documentation for a claim and hand it off to a registered Nurse to assess for the determination. If the claims request was outside of guidelines, it would then be reviewed by a Physician Advisor for a decision.
While at Sedgwick CMS for 9 years, I was awarded for my work. Some of the awards were Coordinator of the month twice, Coordinator of the year twice, as well as winning different “contests.”
I supported the organizations quality programs by being a mentor/teacher to new incoming Coordinators, working in a team environment to meet deadlines, trouble shoot, and meet or exceed performance competencies. This was a very detailed customer and client oriented position.
As a Department Secretary working with Utilization Review, Case Management at The Methodist Hospital in Houston, Texas, for 9 years, I did similar work as well as scheduling tasks and social services work assisting families as well as answering phones and the front desk responsibilities.
Sedgwick CMS: Utilization Review Coordinator August 2008 to August 2017
Methodist Health Services/The Methodist Hospital: Secretary II October 1997 to August 2007
1995-1996 College of the Mainland, Texas City, Texas. Pursuing extensive hands-on, every day computer program classes and use, as well as home based training.
1998 Associates Degree in Speech Communication from San Jacinto Jr. College, south campus, Houston, Texas.
1999 Houston Community College, central campus, Houston, Texas. Completed courses in Medical Terminology, ICD-9 coding, CPT-4 coding, and Insurance Billing.
2000 Attended Lower Extremity Venous Techniques and Procedures Seminar given by Dr. Greg L. Snyder. Topics including varicose veins, veins of lower extremity, injection sclerotherapy, radiofrequency sclerotherapy, and venous Doppler use and reading.
2001 Attended Lower Extremity Venous Techniques and Procedures II Seminar given by Dr. Thomas Sims. Topics including ultrasound guided sclerotherapy, laser therapy, and equipment and instrument use.
2008 Attended Accounts Receivable Collections Workshop given by Ask-Doug Seminars.
Excellent references upon request
Sarah Wilson Smith: 901-***-****
Aprile Edwards, RN : 901-***-****
Lisa Mooney, RN: 901-***-****
Gail Walker, RN: 901-***-****
Debbie Gauldin, Claims Examiner: 662-***-****