Medical Management
Resume:
FRANK A APRAKU
ALHAMBRA, CA **801
EMPLOYMENT HISTORY:
**** -****: HealthCare Partners Medical Group/Physician Associates Medical Group-Arcadia, CA
Position: Utilization Management Coordinator /Reviewer
Duties include review authorization request by applying Medical Guidelines,
Approved, deny or modified, contact with Primary Care Physician and Network Specialist.
2000-2006: Network Medical Management/Allied Physicians IPA- Alhambra, CA
Position : Utilization Coordinator
Duties: reviewed and advised on referral process for authorization, audited all UM
Authorizations for accuracy and Financial Responsibilities.
1999-2000: Care First Health Plan-Alhambra, CA
Position : Claims Auditor and Processor
Duties: Processed Hospital outpatient and In-patient claims
Audited all paid claims for accuracy and compliance.
EDUCATION: 1980- Ohio State University-Columbus, Ohio
Major: Economics and Accounting
PERSONAL: Very detailed resourceful and very dependable, extensive knowledge in HMO/PPO
Utilization and referral Management.
Contact this candidate