Medical Manager

GREGORY S. CLAYTON

**** ****** ******

Los Angeles, CA 90008

323-***-**** Mobile 323-***-****

E-Mail: ******@*********.***

OBJECTIVE

A position which offers a high level of challenge, responsibility and the opportunity for continued career growth, allowing me to fully utilize many years of experience.

SUMMARY OF QUALIFICATIONS

- Monitored training programs to institutions of high learning and educational facilities through demonstrations, research, and lectures.

- Patient assessment, medical evaluation and treatment.

- Certified Medical-Legal Editor in permanent disability which involved internal medicine, neurology, orthopedic, psychiatric, and surgical medicine.

- Marketing and public relations.

- Conducted public-contact programs designed to meet employer's objectives.

- Researched data, created ideas for multiple projects.

- Trained and managed a working staff and achieved significant improvements in their productivity.

- Represented employer's during community projects, social and business gatherings.

- Promoted goodwill through such publicity efforts as speeches, question and answer sessions.

- Medical Record Reviewer in internal medicine, neurologic, orthopedic and psychiatric medicine.

- Dictation of medical and clinical patient records.

- Served as Medical-Legal Liaison, interacting with key decision makers, attorneys and nurse case managers in medical/legal negotiations.

- Organized, reliable, good communication skills, multitasking, accurate in writing and editing skills.

- Disseminated facts and information about organization's activities.

COMPUTER KNOWLEDGE

- High level of computer proficiency; Microsoft Word and Windows, MS Excel

and PowerPoint.

EXPERIENCE

PRIME HEALTHCARE SERVICES INC. (SAN DIMAS COMMUNITY HOSPITAL, San Dimas, California., CENTINELA HOSPITAL MEDICAL CENTER, Inglewood, California.

CDS (Clinical Documentation Specialist) CDI (Clinical information Specialist) (05/2010- To the present). Responsible for conducting clinical based concurrent and retrospective reviews of in-patient medical records to evaluate the clinical documentation which reflects the quality of in-patient care outcomes and reimbursement compliance for acute care services provided. Worked closely with the medical staff and physicians to facilitate appropriate clinical documentation of patient care being provided. Other responsibilities included; conducting documentation reviews on all selected admissions and documenting the clinical/medical findings. I participated in the performance improvement activity directed towards patient care that was medical evidence based. Highly skilled with Medi-tech/3m/EMR coder Desktop operations. DRG/MEDICARE (DIAGNOSTIC RELATED GROUPS) as well as MEDICAL/ALL PATIENT FEFINED DIAGNOSIS RELATED GROUPS (APR-DRGs as of July 1, 2013).

Also, trained in the use of MCG, formerly MILLIMAN CARE GUIDELINES as well as MCKESSON INTERQUAL reference guidelines.

SOLEDAD ENRIGHMENT ACTION EDUCATION CENTERS/COUNTY OF LOS ANGELES, Los Angeles, California.

Case Manager/Educational Mental-Health Care Advisor (2007-2009).

Endorsed and supported by California Governor, Arnold Schwarzenegger as well as Assembly Majority Leader for the state of California, Karen Bass (Supported by Assembly Bill 177) by the County Board of Education. Developed a networking system with community colleges and the local universities so that students can be introduced to the possibilities of positive choices for their future. Developed new employer relationships in order to establish training and internship for students. Acted as a liaison in various departments with School Administrators. Principles and practices of organization and administration supervision, training and performance evaluation, applicable state and federal laws, human behavior and social science. Directed, evaluated, trained and supervised the work of assigned personnel. Analyze and resolve problems. Certified in Comprehensive Sexuality Education Training.

HEALTH MEDICAL MANAGEMENT, Inc. Pomona, California

Medical Consultant/Medical Adviser (2005-2007)

Advised and consulted with Orthopedic Surgeon's regarding examination, diagnosis and procedures in rehabilitation of patients according to the newly established California legislation (2005), per The American Medical Association (AMA) Guides to the Evaluation of Permanent Medical Impairment (Guidelines), 5th edition.

PACIFIC ORTHOPEDIC & REHABILITATION, Los Angeles, California

Medical Liaison/Clinical Support (2003-2005)

A leading medical clinic. Responsible for the coordination of clinical operations, policy and procedural development, overseeing physician staff (orthopedist, internist, psychologist, neurologist, pain management specialist, and neurosurgeons), quality assurance, review of medical records, medical editing, preparation of medical reports, providing outside treatment referrals, recommendation of physical therapy and rehabilitation programs, discharge planning, patient relations, and other administrative functions.

INTERCOMMUNITY MEDICAL GROUP/DR. ROBERT W. HUNT, Torrance, California

Medical-Legal Liaison (2002-2003)

Worked extensively with attorneys, and nurse case managers. Responsible for organization and problem-solving of Workers’ Compensation and private injury medial cases involving disputes and settlements. Direct contact and interaction with litigating attorneys, judges, and Workers’ Compensation Appeals Board. Reviewed medical charts, reports, and medical-legal documents. Worked extensively with patients and clients. Specialized in the orthopedic medicine.

VISTA BAY MEDICAL GROUP, Lawndale, California

Medical-Legal Editor/Medical-Legal Liaison/Medical Records Reviewer (1996-2002)

Served in Clinical Support, while also acting as Medical-Legal Liaison, interacting with attorneys regarding settlement of Workers’ Compensation and private injury cases. Certified Medical Legal Editor/Rater; in internal medicine, orthopedic, psychiatric, and surgical medicine. Handled the dictation and review of medical records. Position required verbal, oral, and written communication skills with vocational rehabilitation counselors and state regulators.

PRIMEDX CORPORATION, Culver City, California

Medical Manager, Medical-Legal Editor (1990-1995)

Acted as Clinical Department Manager. Certified Medical-Legal Editor/Rate in Workers' Compensation, permanent disabilities. Reviewed all initial, follow-up, permanent, and stationary medical reports involving Workers’ Compensation and private injury cases. Reviewed job analysis, laboratory, and medical test results, making certain that the medical examination and diagnosis for all patients were correct and accurate. Also handled the dictation and review of medical records.

AMERICAN RED CROSS, Los Angeles, California

Heart Transplantation, Medical Research Coordinator (1987-1990)

Acted as Heart/Tissue Transplantation Coordinator. Responsible for the surgical removal of human tissue, heart, aortic, and mitral valves for surgical transplantation. Prepared and maintained surgical instruments and other mechanical equipment used for tissue procurement and processing as well as ethylene oxide gas sterilization. Complied tissue services procedure manual (SOAP), as well as the standards of the AATB. Assisted with freeze-drying tissue specimens involving cryopreservation of bone, aortic, and mitral valves. Surgical dissection of hearts for aortic and mitral allografts and tissue identification. Assisted with cardiovascular surgeons in the operating room during open-heart surgeries for aortic and mitral valve implantation. Responsible for analytical research, development, and investigation.

EDUCATION

UNIVERSITY OF SANTIAGO SCHOOL OF MEDICINE, Dominican Republic

Foreign Medical School Graduate (FMG - Not Licensed in the USA).

HOWARD UNIVERSITY, Washington, D.C.

Pre-Med, Major: Biology, Minor: Chemistry.

CERTIFICATIONS

Certified in Workers' Compensation, Editing and Rating Permanent Disabilities.

Certified Impairment Rater in Permanent disability as according to the American Medical Association (AMA) Guides to the Evaluation of Permanent, 5th Edition.

Trained in the Dexter Evaluation and Impairment Rating Software, Cedaron and Acumar Range of Motion Testing.

REFERENCES: Available upon request.

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