Administrative Support Case Management

Beverly Darby

***** ********* ****** *****, #****, Houston, TX

*****.**@*****.*** 832-***-****

Summary

Seeking an Administrative Support position, bringing solid working knowledge of MS Office and eight years’ experience in providing accurate, efficient, and timely administrative support utilizing my exceptional computer skills for the smooth operation of the department/company. Experience

Data Specialist II – Case Management

CHRISTUS Health

Jan 2021 - Sep 2024 (3 years 9 months)

Provided administrative support to Ministry Care Management Director, Managers & Directors, Care Management – Shoreline and South and Director, Utilization Manager.

· Overseen the management of third-party billing, accounts receivables, and office operations by monitoring accounts and unbilled reports, as well as verified that appropriate medical necessity is documented for the service requested

· Provided administrative support to the Case Management Department including supply ordering, laptop and cell phone inventory maintenance, reimbursements, new hire onboarding, and meeting planning/management

· Produced minutes from the quarterly Utilization Management Committee Regional Meeting, processed reimbursements, responsible for department procedures, binders, and presentations Furloughed [Pandemic]

CHRISTUS Health

May 2020 - Dec 2020 (8 months)

During the COVID-19 lockdown period, I was placed on temporary layoff and the employer-employee relationship remained intact.

Project Management Specialist

CHRISTUS Health

Mar 2016 - Apr 2020 (4 years 2 months)

Provided support and guidance for multiple initiatives developed and implemented in the Clinical Operations Department with the intent to transform clinical operations to improve efficiency, effectiveness, and patient safety; served as Project Manager for multiple, interdisciplinary projects as well as report writing for a variety of users.

· Electronic calendar management, travel arrangements, meeting schedules, report and presentation preparation, meeting minutes, conferences, special events, and processed business expenses/ reimbursements

· Requisitioned office and meeting supplies, computer hardware, and specialized software, while maintaining adequate inventory for current and near-future needs in line with corporate policies, as well as staff on-boarding

· Participated in defining the project scope, goals, and deliverables that support business goals in collaboration with other members of the Clinical Appeals Management Team; planned and supervised Beverly Darby - page 1

the work of Clinical Appeal Coordinators and kept team well informed of changes within the project; resolved and/or escalated issues in a timely fashion

· Enhanced department and organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to system accomplishments; and possessed understanding of the Clinical Appeals Management databases used to enhance performance effectiveness

· Facilitated complete and accurate entry of data; ran reports; supported users; facilitated training; and provided technical leadership and expertise for regional users Governmental Appeals Coordinator

CHRISTUS Health

Feb 2014 - Feb 2016 (2 years 1 month)

· Established and ensured workflow continuity while concentrating on administrative appeals and provided support on clinical edit claims review to the regional Recovery Audit Contractor (RAC) coordinators

· Ensured responses to government entities regarding appeals are filed in a timely manner

· Managed large volumes of documents which included copy, fax, and scanned incoming mail

· Maintained AudaPro database system assuring system accuracy; collaborated closely with the appeals nurses and regional RAC coordinators to assure they are informed regarding appeal decisions, denials, and recoupments

Executive Administrative Assistant IV

CHRISTUS Health

Nov 2011 - Jan 2014 (2 years 3 months)

Supported the Senior System Director, Directors of Quality, Patient Safety, Clinical Transformation, Clinical Research Administration, Performance Effectiveness Team, and Physician Development, in Clinical Excellence Services, by coordinating and facilitating the routine activities of the department by performing administrative activities necessary for the efficient and effective operation of the department, while maintaining strict confidentiality of all sensitive materials.

· Coordinated meetings, appointments, and teleconferences, ensuring meeting venues were prepared and meals provided when appropriate; scheduled appointments, arranged travel and prepared travel itineraries to ensure travelers have pertinent information when traveling

· Ensured all meeting materials, if any, were delivered to all participants in a timely and professional manner to ensure adequate time for meeting preparation; prepared presentations and reports as requested, which included PowerPoint, Excel, Word documents, and project management reports

· Attended council meetings, took notes, and drafted the meeting minutes for communication to appropriate associates; processed invoices and reimbursements for CES Department, ordered supplies, and obtained necessary documentation and approvals Data Specialist

Center for Clinical Innovation/Research Institute

Oct 2010 - Oct 2011 (1 year 1 month)

· Entered/validated patient surgical information into the Cedaron database for outcomes management and harvesting, in The Society of Thoracic Surgeons (STS) specialty registry, which are obtained from the nurse data coordinator

· Managed the data input process verifying that all information is entered accurately and timely Beverly Darby - page 2

· Performed quality assurance of each patient's file for accuracy prior to harvesting; reviewed the data quality report, risk score match report, the itemized percent missing data report, and make changes for report re-submission(s) prior to the harvest date

· Assisted with budget issue follow-ups with research finance office by assembling budget packets and resolving budget issues; cleaned up aged patient receivables, aged patient liability reports, and account receivable report for research patients; verified account balance, insurance balance, unbilled balance, patient balance, age, and amount as well as and Assisted grant specialists with file coordination and verification

Education

Prairie View A&M University

Bachelor of Science, Business

1973 - Present

Skills

Excellent organizational skills • effective time management • priority setting • process improvement

• High level of initiative • ability to work in both individual and team environments • Detail-oriented • excellent verbal and written communication skills • initiative-taker • desire to learn Beverly Darby - page 3

Contact this candidate