Administrative Assistant Quality Assurance

CRYSTAL CRENSHAW

ad5dnt@r.postjobfree.com 903-***-****

OBJECTIVE

EXPERIENCE

Dedicated, Administrative Assistant with experience handling a wide range of administrative, technical, and executive - support tasks.

QUALITY ASSURANCE MANAGER

Lifepath Systems MHMR/ McKinney, TX / 2/7/2022 – 3/25/2024

Utilization Management Coordinator provides support to the Utilization/Quality Management Department and medical unit. Performance requires accuracy, attention to details, initiative, and a pro-active approach to duties and responsibilities.

Process and track Utilization Management related issues in accordance with the Managed Care Organization's guidelines for entering and tracking authorizations, processing completed clinical assessments, and researching denial issues.

Assist in preparation of regularly scheduled UM/QM reports, as well as reconciling and tracking data from multiple reports, communicating with applicable parties as needed.

Helps support data collection and analysis for daily operation.

Make corrections to Overlapping Services.

Reviews TAC, Health and Safety Code, External contracts, and other sources regularly to ensure that Policy and Procedures.

Supports compliance with semi-annual satisfaction surveys and responds to death review reporting.

Responsible for knowledge of UM/QM guidelines and updates.

Responsible for batching our MCO Generator Authorizations.

Responsible for insertion of External Reviews on the Submission Calendar

Performs other tasks needed by the team lead, and supervisors.

MEDICAL OFFICE SPECIALIST & UTILIZATION MANAGAMENT TECHNICIAN

Lifepath Systems MHMR/ McKinney, TX / 07/2017 – 02/2022

Performed clerical to include answering telephones, scheduling, following-up on appointments.

Reconcile data from multiple reports.

Verify insurance claims.

Review patients records & make updates.

Assign codes to diagnoses & procedures.

Greet patients with a personalized inviting manner.

Maintain the Providers & counselors, and case managers schedules.

CHILDCARE TEAM LEADER

YMCA- George H.W. Bush Elementary, Addison, TX 09/2016 – 07/2017

Actively engage in activities with participants including physical activity, enrichment activity and Homework/CATCH time implementation

MEDICAL OFFICE SPECIALIST EXTERNSHIP 200 HRS

Synergy MSO, Addison, TX 01/2017 – 04/2017

Reconcile medical billing claims from multiple reports for multiple clinics.

Updated client information in the system for multiple clinics.

Provider Credentialing

Billing & Coding for multiple clinics.

Verify insurance claims.

LEGAL ADVOCATE

Domestic Violence / Texarkana, TX - 11/2013- 09/2015

Provide direct services to victims of domestic violence in the following areas Cass, Bowie, Miller, Lafayette, Little River, & Hempstead Counties. I serve as a representative for victims of Domestic Violence. I also provide direct service responsibilities to include support, information, advocacy, and court accompaniment to victims of domestic violence. Assist with restraining orders, civil, and other court matters, and legal referrals.

MEDICAL ASSISTANT EXTERNSHIP

Good Shepherd – Garrett Clinic, Linden, TX / 06/2013 – 10/2013

Greeting patients and their loved ones in a personalized and inviting manner. Performed clerical to include answering telephone, met, greeted, and seated patients, filed, and verified insurance claims, filed charts, pulled charts, called patients, scheduled patients, packed important items to send out, scheduled payment plans, assisted the Doctor with patients, cleaned tools, took X-Rays, etc. Work collections on past due accounts. Took vital signs, performed phlebotomy, and gave EKG’s, immunizations, and has lab experience.

MEDICAL ASSISTANT

Good Shepherd – Garrett Clinic, Linden, TX / 10/2013 – 09/2015

File and verified insurance claims, filed charts, pulled charts, called patients, scheduled patients, packed important items to send out, scheduled payment plans, assisted the Doctor with patients, cleaned tools, took X-Rays, etc. Work collections on past due accounts. Took vital signs, performed phlebotomy, and gave EKG’s, immunizations, and has lab experience.

CORRECTIONAL OFFICE IV / EDUCATION/ PAROLE

Texas Department of Criminal Justice, New Boston TX / 02/2007 – 09/2013

Participated in the day-to-day operations of the prison, maintaining security of the facility, escorting offenders within and/or outside the secure confines of the prison. Communicated effectively with a varied population of offenders, including individuals from diverse ethnic, racial, cultural, and economic backgrounds. This included persons for whom English was not a primary language, persons with developmental and learning disorders, and individuals with a wide variety of psychiatric and physical disorders.

OFFICE ASSISTANT / MEDICAL FRONT / DATA ENTRY

Cornerstone Staffing / Addison, TX 09/2015- 08/2016

Greet all customers in a timely, friendly, and professional manner. Answer all phone calls consistently and ensure all phone messages immediately communicated to the correct recipient,

SKILLS

EDUCATION

Office Management Support

Reliability and Adaptability

Staff Development & Training

Teambuilding & Supervision

UM/QM Guidelines

Policies & Procedures

Knowledge of TAC, Health, and Safety Codes

Reviewer for Internal & External Audits

Billing & Coding

Medical Billing/Collections

EKG Certified

X-Ray Certified

Phlebotomy Certified with lab experience.

Oral and written communication skills

Report & Document Preparation

HEALTH ADMINISTRATION/ MA

UNIVERSITY OF PHOENIX, PHOENIX, AZ

06/2022- Until

BUSINESS ADMINISTRATION/ BA

COLLEGE OF HEALTHCARE PROFESSIONS, HOUSTON, TX

03/2018-05/2020

HEALTH AND MEDICAL ADMINISTRATIVE SERVICES/AAS

COLLEGE OF HEALTHCARE PROFESSIONS, HOUSTON, TX

10/2017-03/2018

MEDICAL OFFICE BILLING & CODING SPECIALIST/AAS

BRIGHTWOOD COLLEGE, DALLAS, TX

10/2016-04/2017

MEDICAL ASSISTANT SPECIALIST/ AAS

KAPLAN COLLEGE, SAN ANTONIO, TX

01/2013-10/2013

ORGANIZATIONS

POLICY COUNCIL COMMUNITY BOARD MEMBER

HEADSTART OF GREATER DALLAS

09/2020-until

BOARD OF DIRECTORS MEMBER / SECRETARY

HEADSTART OF GREATER DALLAS

09/2020-until

2ND VICE PRESIDENT (MEMBERSHIP)

E.D. WALKER P.T.A.

04/2021-05/2023

2ND VICE PRESIDENT (MEMBERSHIP)

W.T. WHITE PTO

04/2021-until

PRESIDENT

GAMMA PHI DELTA SORORITY INC.

05/2023-until

QUAD STATES REGIONAL YOUTH ADVISOR

GAMMA PHI DELTA SORORITY INC.

10/2020-until

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