Medical Case Claims

SANDY MALONEY

952-***-**** *************@*****.***

Experienced bilingual professional seeking an opportunity where I can utilize my unique interpretive language expertise; specifically in fraud investigations. Extensive track record includes successfully conducting over 12,500 medical patient interpretations. Experience translating medical literature including disciplines of Angioplasty, Bariatric Surgeries, Neonatal and Genetics. Medical case fraud management.

COMPLEX CARE Plan Advisor January 2021 – Present

Knowledge and processing of medical claims

Management of complex cases with a Federal Health care product, Compassrose, for federal employees

Medical case fraud for vision, dental, medical claims and web claims

Overseeing the appeals process

Extensive experience with Jicada, CPS, Epic, VCC, Genesis Phone Systems, HSA and Onbase AM Research Consultant January 2021 – Present

COVID-19 special assignment

Surveying patients who have been infected by the virus and have also been administered a COVID-19 vaccine

Managing HIPPA protectedinformation

Bilingual interpreting

Tracing COVID-19 contact from initial infection and through hospital, both emergency and non-emergency, visits and stays

Utilizing 3CX application and Salesforce

Utilizing VCC and Genesys phone systems

Epic,Maestro, Facets,Maccess

Medicaid and Medicare

TSI SERVICES, LLC, LEAGUE CITY, TX

Owner/President 2014 – Present

Supervision of 50+ employees

Bookkeeping

Certified payroll

Managing contract negotiations with federal government

Additional managerial and administrative responsibilities as needed

Participated in Medical Translations for pamphlets, Medical Books for multiple disciplines and medical procedures. Angioplasty, Neonatal, Genetics, Bariatric Surgery, Knee and hip Replacements to name a few.

Medical Billing for Interpreter Services

HENNEPIN COUNTY MEDICAL CENTER, MINNEAPOLIS, MN

Medical Interpreter, 2001 - 2014

Interpreting for patients to aid in health decision making, explaining circumstances and ensuring the patient comprehensively grasps a situation

Representing the patient verbally

Maintaining precise translation dialogue between the patient and medical professionals

Detailed documentation for every patient interaction

Successfully conducted over 10,000 medical patient interpretations including phone, video and in-person settings

Bilingual Advocate for Medicaid members

HENNEPIN COUNTY MEDICAL CENTER, MINNEAPOLIS, MN

Medical Billing, 2012 - 2015

Interpreting for patients to aid in health decision making, explaining circumstances and ensuring accurate recording off all sensitive, pertinent information CERTIFICATIONS

Interpreting and Translation Certification of Completion - 2008

National Medical Certification from Certification Commission for Healthcare Interpreters - 2011

Cross Cultural Trainer - 2013

Subject Matter Expert Certification - 2017

Subject Matter Expert Certification - 2019

LICENSE

Life Insurance through TDI Texas - License #263601, issued 03/01/2021 REFERENCES

Available upon request

Contact this candidate