**** * **** ******* ****, West Jordan UT ***** Cell:385-***-****

aduwfm@r.postjobfree.com

Objective

I am a dependable team leader, motivated with proficient communication skills. I have efficient computer and data entry skills, along with essential office skills. I have many years of customer service skills and experience in working with students, as well as hospital patients/staff. My ability to listen and communicate to resolve issues in my various jobs has helped me to become an effective resolutionist in just about any situation. My past work and life experience has helped me develop the ability to learn quickly and use the knowledge that I have acquired to move up quickly in several jobs. Along with developing quick knowledgeable skills in different work environments. I have become more aware of using my listening skills to help determine positive and productive outcomes.

EDUCATION

09/1996 to 09/1997 Utah Career College; Medical Admin. Assistant-Insurance Coding/Billing 01/2007 to 05/2009 Dine College; AA-Social & Behavioral Health, Graduated w/Magna Cum Laude EMPLOYMENT

10/2020 to 12/2020 Magellan Health (Select Source Intnl); Utilization Management Specialist

Coordinates entire intake process as necessary w/referral sources, providers, patients, & internal team members.

Preformed the following functions: Intake via phone, referrals; processed thorough, accurate & complete cases & new orders based upon information provided by the requester.

Effectively communicated referrals, status updates to all departments.

Used basic medical terminology, used excellent time management & muli-tasking skills; thrived in an ever- changing environment. I used a high degree of customer focus & attention to service detail. My strong computer skills w/basic Microsoft word & excel helped in communicating with clients, patients and team members.

Used experience with medical coding (ICD-9, CPT/HCPCS, & PBM-Pharmacy Benefit Management)

Used Avaya One phone system, Microsoft teams, Zoom, RITA, Workday, Adobe Reader. 11/2019 to 05/2020 Stryker(Radiant Systems); Data Entry/Cust. Service Orthopedics Billing

Inbound calls from hospitals or sales agents were answered to help w/questions on ordering surgery parts & tools for orthopedics surgery.

Worked with Oracle program, Microsoft office, WebOps, and general computer programs.

Maintain attention to detail for data entry of sales equipment sent out, entered billing data and submitted PO’s for processing as well as collections of payments.

Worked efficiently and effectively w/in multiple software data programs at once.

Entered all surgery sheet information in the client case & sent out sales sheet, received returns on equipment/entered that return to help issue a credit to that hospital. 05/2019 to 08/2019 Discover Card; Fraud Specialist(CPS)

Developed & maintained working relationship w/departments w/in Discover card corporation. Made effective decision-making skills and recognized the appropriate action needed when reviewing transactions.

Inbound calls from Discover Card members & non-members to gather info regarding incidents of fraud.

Verify card members through various steps of verification & software (Innovis OTP)

Maintain attention to detail of fraud activity; worked efficiently & effectively w/in multiple channels of alert systems.

Monitor & reviewed suspicious trans.; made ph calls on alerts we received for our members accnts & seeked quick & accurate resolutions.

Made effective decision-making skills & recognize the appropriate action needed when reviewing transactions. 05/2018 to 3/2019 Federal Occupational Health(Ingenisis) Medical Billing/AMA-Account Mang. Assistant 03/2018 to 05/2018 Mitchell International(Search Group) Medical Billing/Data Entry

General Medical billing duties; organize medical exams, request missing docs

Use STM application to bill medical exams; enter data of medical exam into another system for medical review.

Work w/other federal agencies/clinics & private clinics daily to help make appt for yearly exams, along w/addtnl immunizations or repeat exams.

Handled 6 different Federal agencies with FOH. W/Mitchell International I handled several different regions of US. Worked independently entering exam info, bill exams properly send out original exams to agencies via UPS,

& sent out medical review letters to employers & the examinee. Worked w/deadlines & high pace environment. 09/2016 to 03/2017 Utah Navajo Health Systems, Patient Registration 04/2016 to 8/2016 Tuba City Regional Health Care Corporation, Patient Registration

Input correct patient data & current insurance at time of registration for return/new patients.

Help patients w/referrals to Patient Benefit coordinator to help apply for medical insurance.

Worked w/several departments to ensure accurate insurance info for billing purposes.

Used multiple data bases to verify insurance benefits & eligibility.

Moved at a moments notice from one part of hospital to another; called in as well to fill in for other departments of registration; travel to other hospitals as needed. 10/2014 to 05/2016 Kinlani Flagstaff Dormitory, Residential Assistant

Worked w/Native high school students

Tutor in all areas of education

Counseled in every day aspects of students; helped in applying for college & other clubs

Sponsored the Navajo Cultural Club

Ensured safety of students in check out process as well as medical response. 09/2008 to 05/2014 Kayenta Unified School District #27, Pool Manager, ARC Lifeguard Instructor, Swim Instructor, District Sub., & Timesheet Dist. Clerk

Manager duties: timesheet keeping, correcting missed punches, turning in timesheets on time for payroll.

Kept records for budget; buying needed pool chemistry supplies, lifeguard supplies, water safety equipment.

Kept building up to OEH standards, to keep pool open for class, team building & Crisis management teams.

Managed American Red Cross standards as an Authorized Provider to operate under rules & regulations; kept up lifeguard Instructor Certification & Water safety Instructor. Oversaw WSI I instructor for KUSD students & staff fundamentals of swimming.

District substitute duties for grades K to 12th grade.

TS District Clerk: I helped in the business office w/bank reconciliations, handled club budgets, maintain records for an other areas that the business personal needed. SKILLS

Fluent in Navajo

Detail orientated & an excellent problem solver.

Possess strong organizational & analytical skills

Proficient in: Adobe, Microsoft Office (Word, Outlook, Excel, Publisher, Powerpoint, SharePoint, Microsoft Office Teams, Jabber, Webex, Cisco Desktop, Orion, Integrate, Avaya One-X, RITA, Workday, Zoom, & business intranet systems)

REFERENCES: Available upon request

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