Data Entry Help Desk
Resume:
MATTIE SMITH
Wylie, TX ****8
Cell Phone: 469-***-****
adv246@r.postjobfree.com
Summary of Skills
Great interpersonal skills, verbal and written communication skills
Great organizational skills, Sound decision-making skills
Detail oriented
Analytical, diplomatic, flexible, and responsive
Ability to meet deadlines in a frequently changing environment
Microsoft Word, PowerPoint, Excel, Lotus Notes, SharePoint, NICE, Microsoft Teams and Outlook knowledge
Experience in multi-tasking and prioritizing in a variety of settings
Professional Experience
Health Care Services Corporation
Richardson, Texas
May 2000-present
Enterprise Healthcare Management Health Coordinator:
Responsible for contacting members to inform and educate them on our medical management programs, conducting research, performing data entry, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities
Performs ongoing functions to support the Medical Management department, including one or more of the following:
Perform outreach and follow up attempts to members. Inform and educate members on the medical management programs, using supplied scripts. Complete records in system by performing data entry. Encourage member usage of our programs. May include scheduling appointments. Generate appropriate correspondence and send to member manually or electronically.
Maintain production requirements based on established department business needs.
Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate and close a case within the platform.
Receive, analyze, conduct research and respond to telephone and/or written inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party.
Notify help desk of system issues.
Perform data entry function to update customer or provider information.
Serve as contact for medical necessity review/network steerage for pending transplants. Monitor the case management work queue for pre-transplant outpatient cases, initiating new pre-transplant cases. Verify eligibility and network requirements using the medical management system as well as other resource as appropriate. Serve as a liaison between Medical Management and BCBSA and as a resource for providers and/or members.
Obtain required or missing information via correspondence or telephone.
Serve as contact for the FSU regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from FSU, reopen or initiate new cases as needed and refer case to clinicians.
Support and maintain communications with various in-house areas regarding groups’ concerns, i.e.: Marketing, Provider Affairs, and SSD.
Communicate and interact effectively and professionally with co-workers, management, customers, etc.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
Maintain complete confidentiality of company related business.
Maintain effective communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
Education and Certifications
Performance Masters; Dallas, TX Medical Assisting/X-Ray/NCT Certificate Program
Trinity Valley College-General Studies
University of Phoenix-General Studies
Hawkins High School-High School Diploma
Clinical Skills- Taking Vital signs, assisting in physical examinations, Biomedical waste disposal, Electrocardiography, Clinical Asepsis, Laboratory skills-Phlebotomy(Finger Sticks and Venipuncture),Urinalysis and Specimen Collection
Computer Skills-Microsoft Word, Power Point, Access and Excel, Sound decision-making skills, Lotus Notes and Outlook knowledge, Great interpersonal skills. Attention to detail oriented oral and written communications skills. Experience in multi-tasking and prioritizing, high degree of willingness to a variety of settings.
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