Medical Management
Resume:
Rancho Dominguez, CA *****
Mrstil l acaz06@r.postjobfree.com
Teneika tillis
Healthcare professional with over 20 years’ experience working in all
OBJECTIVE
aspects of the delivery of healthcare including; patient care, claims and
managed care, coordinated and facilitated business functions in support of
department operations/administration to include generation of reports.
E xcellent problem resolution and service delivery. I was awarded
employee of the month while working for Aetna Healthcare due to the fact
t hat I saved the company from being audited, also I assisted with
developing a spreadsheet that was able to t rack every claim that went out
for payment. I am looking to work for a company that will allow me to
contr ibute my skills and knowledge to the organizations success.
• Claims Processing
SKILLS &
• Human Resource Management
A BIL ITIES
• Microsoft Office
• Business Operations
• Compensation
• Medical Terminology
• Proficient and skilled in computer applications
• Excellent organizational and interpersonal skills
• HMO,PPO, CPT, HCPCS
• Windows Operating Systems
• Customer Relations
• Type 70+ WPM
• Analytical Thinking skills
• ICD-9 & HCPS
EXPERIENC ADM I T T I NG SUPERV ISOR, UN I VERSI TY OF TEXAS HEALT H
E SCIENCE CENTER AT HOUSTON
The University of Texas Health Science Center at Houston (UTHealth),
t he most comprehensive academic health center in t he UT System and the
U.S. Gulf Coast region, is home to schools of b iomedical
i nformatics, b iomedical sciences, dentistry, medicine, n ursing and p ublic
health .
12/2011-05/2013
• Responsible for supervising the admit ting staff, including but
not limited to in service education, staff organization, evaluations,
quality improvement, and guest relations to help improve patient
satisfaction .
• M aintains open communication with the Nursing Supervisor,
B usiness Office, Radiology, Laboratory Services, Surgery, and the
Benefits and Scheduling Coordinator
Contracts SPecialist I I, Healthcare Partners - a managed care p rovider,
based in Torrance, California, and was formed in 1992 when Los Angeles-
based California Primary Physicians, Pasadena-based Huntington Medical
G roup, and East Los Angeles based Universal Medi-Co joined forces.
03/2011-12/2011
•Contracted new physicians under the medical group
•Promoted to a lead position for assisting with developing
a spreadsheet to t ract all claims going out for payment
• Received employee of the quarter award.
• Supervised department of 13 members
CLA I MS REPRESENTAT IVE, H EALTHCARE PARTNERS
03/2007-03/2011
•Obtained information from policyholders
•Verified claims for accuracy
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•Analyzed and audited all claims paid incorrectly
Claims Benefits Specialist, Aetna Us Healthcare - an American managed
health care company, providing a range of t raditional and consumer
d irected health care i nsurance products and related services, including
medical, pharmaceutical, dental, behavioral health, group life, long-term
care, and disability plans, and medical management capabilities. Aetna is
a member of the Fortune 100.
09/2001-12/2006
•Processed and analyzed claims into med iSOFT system
•Maintained production and quality standards
•Processed medical claims and verified eligibili ty status
•Verified hcps, cpt and ICD 9 codes
•Assisted the company with auditing claims
•Received employee of the month award
CLIN ICAL PARTNER CNA, CEDARS SINAI MEDICAL CENTER -is a
non-profit, tertiary 958-bed hospital and multi-specialty academic health
science centre located in A ngeles, California . Part of the Cedars-Sinai
Health System, the hospital employs a staff of over 2,000 physicians and
10,000 employees. A team of 2,000 volunteers and more than 40
community groups support a patient-base of over 16,000 people.
08/1993-01/2000
•Provided patient care and monitored vital signs
•Admit ted and Discharged patients, assisted with code blue emergency
p rocedures
•Assisted with saving multiple patient lives by quickly responding to
emergency situations
EDUCATION DEVRY UN I VERSI TY, POMONA, CA BACHELOR OF SCIENCE I N
T ECHN ICAL MANAGEMENT
concentration in Health Services Management
GPA 3.45
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Dean’s list recipient
Completed September 2013
KELLER GRADUATE SCHOOL OF MANAGEMENT, POMONA, CA
M ASTERS I N BUSINESS ADM I N ISTRATION
concentration in human resource management
complete September 2014
UN I TED EDUCAT ION I NST I TUTE, LOS ANGELES, CA
C ERT I F ICATE I N BUSINESS ADM I N ISTRAT ION
Completed May 2000
KNOWLEDGE M I CROSOFT OFF ICE, DATA ANALYSIS, M E D ICAL CLA I MS,
C O M M ERC IAL I NSURANCE PRO DUCTS, TYPE 70WP M,
S UPERV ISOR EXPER I E NCE, CPT, I C D9, HCPCS, 10 KEY BY
T O UC H, HOSP I TAL EXPER I E NCE, MANAGE D CARE
E XPER I E NCE, CONTRACT I NG, CLA I MS APPEAL PROCEDU RES,
I NSURANCE E L IG IB I L I TY, H I PPA KNOWLE DGE, M E D ICAL
T ER M I NO LOGY, VERBAL AND WR I T T E N CO M M U N ICAT IO N
S KI L LS, M ULT I TASKER, ORGAN IZAT IONAL SK I L LS, BUS I NESS
O PERAT IO NS
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