Document Coordinator with Remote-Ready Precision

CLAUDIA G. BOAH

************@*****.*** Washington, DC 443-***-**** Claudia G. Boah, MHA LinkedIn

Leadership Strategist Operations Trusted Advisor Patient Satisfaction Cost Saving Healthcare Administration Leader Driving Results by Leading Effective Business Initiatives and Supporting Excellent Patient Care and Satisfaction EXECUTIVE PROFILE

Impact-driven Utilization Review and Case Manager with Master's in Healthcare Administration. Achieved 18 years of progressive experience delivering productive leadership by leveraging healthcare systems' operational excellence and strategic growth. Supports and elevates patient care with productive utilization. Ensures quality care management, applicable resources, and optimal services. Applies strong leadership, communication, and problem-solving skills. Streamlines business processes and reduces costs by leveraging advanced knowledge of healthcare systems, operations, policies, and regulations. Experienced in driving strategic growth and patient-centered care in healthcare organizations. AWARDS AND RECOGNITION

The National Society of Leadership and Success (NSLS), 03/2025 2x Recipient of MedStar Spirit Ward (Patient Appreciation), 12/2022 Upsilon PHI Delta (UPD), 05/2024

AREAS OF EXPERTISE / CORE COMPETENCIES

Leadership: Strategic Planning, Analytical Thinking, Budget Management, Process Improvement, Thought Leadership, Quality Assurance, Patient Satisfaction, Goal Achievement, Complex Problem-solving, Delivers Results. Influence: Relationship Building, Training, Mentorship, Team Building, Cross-functional Collaboration, Partnerships, Communication (verbal, nonverbal, written, and visual), Trusted Advisor, Building Shared Vision, Advocacy. Operational Excellence: Cost Saving, Operations, Profitability Analytics, Data Analysis, Business Acumen, Regulatory Compliance, Risk Mitigation, Quality Assurance, Patient Satisfaction. TECHNOLOGY, METHODOLOGIES, BUSINESS TOOLS, LANGUAGES Project Management/Office Software: Visage, IDX, Aria, Epic, MedConnect, Snappy, PeopleSoft, Nextgen, Cerner, Athenahealth, Tebra.

Budget Planning Software: Good Budget, Spreadsheets, Worksheets Time Management Software: Outlook, Google Calendar, Doodle, and Appointed Operating Systems: Microsoft Office Suite

Languages: Standard American English, Creole, and Pigeon English PROFESSIONAL EXPERIENCE

WCRX HEALTH, Tallahassee, FL 03/2024 – Present

Utilization Review Specialist (Remote)

Analysis/Cost Saving: Analyzed patient records; collaborated with healthcare providers to assess the necessity of proposed services; reduced unnecessary procedures by 18%, saving costs and improving patient outcomes.

Policy/Regulatory Compliance: Ensured services aligned with insurance policies and regulations; achieved 98% compliance rate during audits, mitigating financial risks and enhancing organizational credibility.

Clinical Assessment/Resource Utilization: Conducted comprehensive medical necessity reviews using established guidelines such as Milliman and InterQual; delivered appropriate care levels for patients, optimizing resource utilization and alignment with payer requirements.

Stay Length/Discharge Planning: Reviewed/assessed hospital stay lengths; collaborated with healthcare teams to determine appropriate discharge plans; reduced unnecessary extended hospitalizations, saving costs and improving patient flow.

Insurance Liaison/Authorization: Initiated/managed communication with insurance providers, obtaining authorizations and resolving coverage issues; secured timely approvals for treatments, minimizing delays in patient care, and ensuring compliance with insurance policies.

Service Denial Appeals/Documentation: Reviewed/appealed denied services by providing appropriate clinical information and documentation to insurance companies; achieved high success rate in overturning denials, ensuring patients received necessary treatments, and maintaining revenue integrity.

Cross-functional Collaboration/Care Delivery: Collaborated with interdisciplinary teams during care planning rounds; guaranteed utilization review criteria met and addressed discrepancies; elevated team communication and alignment, uplifting more efficient care delivery, and reducing risk of denials.

Data Analysis/Quality Improvement: Monitored utilization data, identifying trends, patterns, and opportunities for improvement; discovered actionable insights informing policy adjustments and process improvements.

Training/Mentorship: Trained healthcare providers/staff on utilization review processes, guidelines, and requirements; improved knowledge/adherence to utilization review protocols and more efficient and compliant care delivery.

GEORGE WASHINGTON UNIVERSITY HOSPITAL, Washington, DC 04/2023 – 01/2024 Case Manager

Care Coordination/Patient Satisfaction: Coordinated comprehensive care plans for patients; ensured access to necessary resources and services, improving patient outcomes and satisfaction by facilitating timely and appropriate interventions.

Cultural Interpretation/Communication: Supported patients and families navigating complex healthcare systems by providing medical and social interpretation services; enhanced patient understanding and compliance, leading to better health outcomes.

Advocacy/Negotiation: Advocated for clients in legal and medical settings, conducting prior authorization and ensuring fair treatment; secured necessary services and support for clients, reducing barriers to care. Skil

Interdisciplinary/Teamwork: Collaborated with doctors, therapists, nurses, and other medical professionals to develop comprehensive treatment plans for patients; improved holistic care that addressed all aspects of patient health and impacted overall well-being.

QUADRANT INC, Washington, DC 11/2022 – 04/2023

Executive Administrative Assistant

Client Relations/Communication: As primary contact point among executives and internal/external clients, managed inquiries/requests, built relationships, facilitated communication channels, and delivered resources.

Budget/Expense Management: Managed expense reports and budgets, ensuring accurate processing and adherence to financial policies; reduced errors by 15% and maintained budget compliance. DAVITA RENAL CARE, Washington, DC 07/2018 – 10/2022 Facility Administrator 06/2020 – 10/2022

Operations Management/Service Leadership: Oversaw daily operations of facility, managing and ensuring all services effectively delivered and facility needs consistently met; championed and elevated operational efficiency and tenant satisfaction.

Stakeholder Engagement/Contracts: Implemented ongoing contract review programs to assess client, tenant, and occupant needs; enhanced service delivery by aligning with stakeholder expectations.

Budget Configuration/Forecasting: Developed and explained annual facility budgets and forecast business plans; ensured financial planning aligned with organizational and budgetary goals.

Clinic Hemodialysis Technician 07/2018 – 05/2020

CREATIVE CONCEPT LLC, Hyattsville, MD 10/2015 – 06/2018 Assistant Director/Program Coordinator

FRESENIUS MEDICAL CARE NORTH AMERICA, Washington, DC 08/2008 – 09/2015 Certified Hemodialysis Technician

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Claudia G. Boah – Resume

EDUCATION, CERTIFICATIONS, CREDENTIALS, PROFESSIONAL DEVELOPMENT UNIVERSITY OF MARYLAND GLOBAL CAMPUS, Master of Healthcare Administration, Maryland, MD, 12/2024 Certification in Leadership and Management

COLORADO TECHNICAL UNIVERSITY, Bachelor of Science in Business Administration, Denver, CO, 12/2021 Minor in Development

EVEREST COLLEGE, Associate of Applied Science in Medical Assisting, Silver Spring, MD Certification of Clinical Hemodialysis Technician

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Claudia G. Boah – Resume

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