Medical Manager
Resume:
AVERY RAGLAND Home: 423-***-****
**** ***** **** **, ***********, Cell:
Chattanooga, Tennessee 37406 E-mail:
**********@***.***
Offering over twelve (12) years experience
in client solutions and service delivery
A self-starter with strong organizational and prioritization skills.
Proven ability to enhance operational efficiency and affect
productivity in nonprofit and government settings. Lifelong commitment
to learning. In the past, I have had the opportunity to train,
facilitate, coordinate, motivate, and strategically develop teams to
work within state government and non-profit agencies. Excellent oral
and written communication skills. Specializing in the following:
. Health Care
. Case Management
. Client Interviewing
. Program Implementation
. Customer Service
. Budget Development
. Federal Grant Compliance
. Implementing Diversity
EDUCATION
University of Regis
Post Bachelors HIM Program
2012-Present
18 hours completed (Part-Time)
Chattanooga State Tech Community College, Chattanooga, Tennessee
Computer Networking classes Present
University of Phoenix, Chattanooga, Tennessee
Masters in Business Administration (M.B.A), Completed May 2008
Major: Business Administrations/ Healthcare Management
Northwestern Technical Community College, Rocksprings, Georgia
Certificate Program Completed 2007
Medical Coding
Middle Tennessee State University, Murfreesboro, Tennessee
Bachelor of Business Administration (B.B.A), Completed
December 2002
Major: Business Administration
Minor: Economic Finance
Chattanooga State Tech Community College, Chattanooga, Tennessee
Certificate Program, Completed 1998
Emergency Medical Technician (EMT)
WORK EXPERIENCE
Part-time Adjunct Professor: Contract Positions
. Virginia College of Business: 2008-
2013
o Teaching: Business Classes, Basic Math, Pre-Algebra, and
Algebra Classes.
. Northwestern Technical Community College: Online 2008 to 2012
o Teaching: General Education, Health Information Management,
Medical Transcription, and Business Classes
Dodson/Southside and Erlanger Health Systems
Team Leader/Community Access Facilitator
2008-Present
Duties: Must have knowledge and skills to demonstrate medical
terminology, insurance, and general medical coding skills to process
the needs of internal and external clients. Job duties include having
the skills, knowledge and ability to be a self starter and transition
quickly between multiple systems (Flowcast, Ibex, Invision, and EMR).
I have worked with ER physicians, nurses, and social workers as it
relates to evaluating medical needs, health care procedures, and
patient placement as it relates to discharging, planning, and pre-
certifications while maintaining EMTALA, JACHO, and Medicare and
Medicaid compliance. My experience also includes: educating,
training, facilitating, and implementing policy and procedures
relating to patient care (outpatient and inpatient). I have the skills
and knowledge to network with organizations within the communities and
diverse populations. Adopting and strategically implementing
procedures to address internal and external concerns. I have chaired
meetings; served as liaison among internal and external clients within
the communities. I process daily operational needs, collecting co-
pays, and other potential issues within a clinical setting.
Medical Services
Account Rep: A/R and Billing (Temp Assignment) 2013
Duties: Process claims for physicians. Must have skills and knowledge
of medical terminology, coding, processing corrective claims, and
appeals. Must be able to effectively communicate with physicians,
insurance providers, and staff in providing effective customer
service. Must have the skills and knowledge to utilize Nextgen,
Encounterpro, Availity, Realmed, Xtender, EHR, EMR, and Citrix while
maintaining HIPAA compliance. Must be able to utilize a variety of
systems to access and upload insurance information.
State of Tennessee Department of Human Services
Eligibility Counselor - Case Manager
2005 to 2008
Duties: Maintain knowledge of Medicare and Medicaid policy and
procedures. Interview clients for government grants and conduct case
investigations (ex: Food stamps and Medicare/Medicaid fraud). Provide
case management to Medicare and Medicaid clients. Job included
documenting government compliance; process client Medicare and
Medicaid appeals. Meeting deadlines is crucial as it relates to
Medicare and Medicaid policies and procedures. Utilize multiple
systems in order to appropriately process appeals and provide
recommendations for improvement. Provide adequate documentation
pertaining to federal guidelines and Health Information Portability
and Accountability Act (HIPAA). Work under stressful conditions.
Utilize MS Word and the Internet to communicate effectively.
Partnership Family Children Services
Transitional Case Manager 2004 -
2005
Duties: Managed transitional homeless shelter. Develop activities and
training materials for shelter. Implement events and workshops during
community fairs. Posted weekly/monthly accounts, generate spreadsheets
utilizing Excel, and developed individual budget plans. Attended grant
writing seminars. I worked closely with the director, coordinator,
operations manager, and external agents (e.g., HUD and State Grants)
in developing an effective program.
State of Tennessee Department of Children Services
Probation Office - Case Manager 2003 to
2004
Duties: Case managed juveniles in state custody. Communicate with
Bureau of TennCare as it relates to clinical care (EPSDT and
psychological exams). Prepare legal documents for court (petitions,
affidavits and court reports). Duties include interviewing clients for
various government programs. Work under stressful conditions.
Implement diversity (being able to work with different cultures while
implementing policies and procedures).
Middle Tennessee State University
Resident Assistant 2000 -
2002
Duties: Planned and coordinated activities (120-300 students). The
goal was to increase student retention among freshmen students. Engage
students and establish a community among them while promoting
diversity. I conducted operational procedures (room and equipment
inspections).
TN Aquarium
Emergency Medical Technician (EMT-Basic)/Security 1999
Duties: Dispatch. Monitor visitors and employees and it relates to
safety, assess patients who are en-route to emergency facilities as
directed by medical control, reports verbally and in writing medical
observations, and provides assistance to receiving medical facilities
and staff.
COMMUNITY ACTIVITIES
. Health Disparities Task Force: Present
. Scholarship Committee: Pure Holiness Church of GOD: Present
. Basketball Camp for at Risk Youth 2011
. Hamilton County Task Force (Reduce truancy among school
students) 2005
. Children's' Health Fair: 2004
. Volunteer, Erlanger Hospital, 1996-1998
COMPUTER SKILLS
. Word, Excel, Power-point, Publisher, Word Perfect, Alex and
Minitab.
. Internet Searches, Angel, Blackboard, Accent, Access, Statewide
System Main-Frame (Child-support, Edison, Refuges, Unemployment,
Medicaid/Medicare), and Data Entry
. Invison, Flowcast, Cintrix, Access, IBEX, and Electronic Medical
Records (EMR)
. Encounterpro, Nexgen, Realmed, Xtender, Citrix, Electronic
Health Records (EHR)
Professional References
Dr. Andrea Goins (Physician)
975 East 3rd St.
Chattanooga, TN 37404
423-***-****/834-5992
Dr. Andrew Combs (Physician)
9527 Ridge Trail Rd
Chattanooga, TN 37379
(423) 423-***-****/706-***-****
Naomi Powell (RN)
332 Osceola Dr.
Whitewell, TN 37397
423/802-4448/423-***-****
Cheryl Smith (Social Worker)
Erlanger Health Systems
975 East 3rd St
Chattanooga, TN 37404
Lisa Youngblood
Medical Services
2810 Walker St
Chattanooga, TN 37406
Wilma Wiley, (Supervisor)
State of TN: Dept of Children Services
300 Eastgate
Chattanooga, TN 37411
Marie Mitchell, HR Representative
The Partnership for Families, Children & Adults
300 E. 8th Street
Chattanooga, TN 37403
Phyllis Gore, (Team Leader)
State of TN: DHS
540 McCallie Avenue, Ste. 300
Chattanooga, TN 37402
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