Customer Service Medical Assistant

Shelia Chism

317-***-**** advlfp@r.postjobfree.com Indianapolis, Indiana 46254

SUMMARY

Dear Personnel Interviewer, I am seeking the opportunity to apply myself to the position posted, which will enable me to contribute both my education and professional experience, which will also allow me to progress in my career. The open position is ideal prospect, in view of my experience, education, skills and career interests. According to my resume, I have gained twenty one years of practical work experience within the medical field. The position posted will allow me to develop additional analytical skills, where I can be able to gained valuable insight and hands on experience handling medical responsibilities. Considering my credentials and qualifications, I profoundly believe I am a suitable candidate for the open position. I am highly committed, and a conscientious individual with a reputation that speaks for itself. My skills and ability will be an asset to your organization. My resume is enclosed for your consideration; I look forward to your response at your earliest convenience. Objective: Outstanding and awarded candidate, who is committed to provide exceptional care as an integral member of any medical service care team, Highly qualified to provide effective leadership, with a focus on total organizational; coordination to efficiently provide innovation conceptions. I am considered as a seasoned candidate with an outstanding expertise in the medical field and in administrative and secretarial duties. Summary of Qualifications: Excellent clinical, customer service and communication skills. Excellent verbal and writing skills, ability to quickly learn new concepts and skills. Knowledge of medical terminology and program administration with training and development. SKILLS

CPR

Medical Terminology

Microsoft office

power chart

CRM

Cerner

Web Interchange

Excel, Word

EXPERIENCE

Coordinator, Evolent Healthcare, July 2015-January 2023 Indianapolis, IN

Responsible for independent research, evaluation and authorization of the requested medical services which have multiple payer coverage limitations The position is responsible for timely accurate incoming telephone communication with medical providers regarding medical benefits, referral status and prior authorizations. Reviewed patient admissions to determine medical necessity as directed by Medicare criteria. Determined medical necessity and cost-effectiveness of services through utilization review processes.

Remained up-to-date on various benefit plans, medical policies and state-specific clinical guidelines or criteria.

Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.

Contacted insurance carriers to obtain authorizations for services delivered to patients. Member/Provider Services Representative (Call, Center Rep), Aerotek- MHS, Manage Health Services, February 2014-July 2015

Parkway, Plainfield, Indiana

Incoming Members/Providers call for eligibility, Benefits, Payments and claims Delivered fast, friendly and knowledgeable service for routine questions and service complaints.

Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance.

Handled escalated customer service concerns to preserve customer satisfaction and maintain long-term business relationships.

Patient Care, Indiana University Health, Methodist Hospital, Neuro Critical Care, March 1995-October 2014

Indianapolis, Indiana

Sec/Unit Sec

Entering physicians' orders, communicating with physicians and nurses, recording lab results, responding to code blues, reporting RHC (respirations has cease) to IOPO (Indiana Organ Procurement), paging and answering high volume of calls as well as filing paperwork, medical records and interacting with family members.

Ordered and maintained supply inventory for medical office. Scheduled tests, lab work or x-rays for patients based on physician orders. Arranged hospital admissions for patients as required. Transmitted medical records and other correspondence by mail, e-mail, or fax. EDUCATION AND TRAINING

Qualified Medical Assistant

Health Administration, Ivy Tech Community College of Indiana, Indianapolis IN June 2015 Qualified Medical Assistance), Certified Nursing Assistance, (Certified Nursing Assistant) Ivy Tech Community College, QMA

Patient Care Secretary – Medical Terminology, 1995 Methodist Hospital Unit Secretary Adjunct Instructor - IU Health, Methodist Hospital Leadership and Training for New Orientees – IU Health, Methodist Hospital REFERENCES

References : Relationship / Years Known: Jessie M Koers-White, NP-C Colleague 17 years Goodman Campbell Brain and Spine Indianapolis, Indiana 46202 317-***-****

/advlfp@r.postjobfree.com Elliott Levine, PA-C Colleague 11 years Goodman Campbell Brain and Spine Indianapolis, Indiana 46202 317-***-****/alevine@goodmancampell.com_ Stacey Cruthers Colleague/Peer 12 years Indiana Organ and Procurement (IOPO) Indianapolis, Indiana 46222 317-***-**** Stacey_Cauthers@yahoo.com_ Kevynn D. Velasquez Colleague/Peer 22 years Neuroscience Critical Care (NCCU) Indianapolis, Indiana 46202 787-***-**** / advlfp@r.postjobfree.com

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