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Work from Home

Location:
Las Vegas, Nevada, United States
Salary:
$50,000.00/year
Posted:
March 21, 2011

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HEATHER M. RATHBUN, CMA

Las Vegas, NV

efrzfg@r.postjobfree.com

Sales Support and Customer Service Professional with more than fifteen years of experience in the healthcare field. Areas of expertise include provider relations, manage care, contracts, enrollment and eligibility, and account management. Computer proficient in typical business software applications, including MS Office (Word, Excel, PowerPoint, Outlook), Facets and NetSuite. A professional who works well remotely by building effective relationships with colleagues through collaboration to solve problems and issues.

PROFESSIONAL EXPERIENCE

PROVIDER RELATIONS REPRESENTATIVE January 2007 – January 2011

Universal American Corp., Houston, TX

• Built professional, long-term and trusting relationships with providers in various territories across the country, including California, Nevada, Illinois, Iowa, New York, Vermont and New Hampshire

• Recruited and educated new providers, provider groups, hospitals and other healthcare facilities

• Investigated, resolved and followed through with claims, recoupment, provider maintenance, enrollment/eligibility and other issues

• Researched, compiled and distributed various territory reports as requested by management

• Worked well independently as well as collaborate with fellow Provider Relations Representatives and other internal departments

• Supported and assisted agents & brokers with various issues

• Represented organization at Rural Health conferences and various other conferences

• Planned and managed special projects, such as identified and worked with providers to assist with Beta Testing of Provider Portal, “Do Not Recoup” list, NetSuite data clean-up, and Chart Review projects

FIELD CASE/ACCOUNT MANAGER June 2005 – November 2006

Hoveround Corporation, Sarasota, FL

• Placed marketing calls to medical accounts with territory

• Built long-term relationships with medical groups, rehab centers, etc.

• Coordinated and conducted presentations and in-services to referral community

• Negotiated with non-contracted health plans and/or medical groups

• Documented and maintained files on all referral source contacts

• Visited physician offices to obtain documentation on difficult accounts

• Made phone calls to physician offices to obtain necessary documentation

CONTRACT SPECIALIST February 2002 – June 2005

Medtronic MiniMed, Northridge, CA

• Served as a liaison between Medtronic MiniMed and the payors

• Partnered with the Managed Care Account Managers in acquiring and maintaining ancillary provider contracts

HEATHER M. RATHBUN, CMA Page Two

CONTRACT SPECIALIST (continued)

• Negotiated discounted rates with prospective payors for single- case agreements

• Handled field inquires and researched issues from other intra-company departments regarding payor issues

• Assisted the Managed Care Account Managers with various tasks and issues

WESTERN DIVISION SALES ASSISTANT SUPERVISOR February 2001 – February 2002

MiniMed, Sylmar, CA

• Proofread and produced QC Letters of Medical Necessity and Certificates of Medical Necessity

• Led daily meetings and organize/co-led monthly meetings

• Served as General Supervisor and Safety Leader

SENIOR INSURANCE SPECIALIST September 1998 – February 2001

MiniMed, Sylmar, CA

• Verified health insurance benefits and explained benefits to customers

• Obtained pre-authorizations from insurance companies for Insulin Pumps and Supplies

• Provided inside sales

• Discussed finances and payment options with customers and processed orders

MEDICAL ASSISTANT January 1998 – September 1998

Arthritis, Orthopedic and Sports Medical Center, Glendale, CA

• Basic back office medical assistant duties

• Scheduled surgeries, including requesting authorizations, preparing pre-operative reports, etc.

• Answered patients’ questions and relayed messages between patient and doctor

EDUCATION

Pasadena City College, Pasadena, CA; Certificate of Achievement in Medical Assisting; July 1999

Los Angeles Pierce Community College, Woodland Hills, CA; A.A. Degree in Liberal Arts; May 1995

CERTIFICATES, TRAINING & ACTIVITIES

Certificated Medical Assistant Credential

Certificate of Achievement in Medical Assisting

Externship at Verdugo Hills Medical Association Urgent Care

Exceptional Customer Service by Fred Prior Seminars

The Effective Public Speaker at Los Angeles Pierce College

Juvenile Diabetes Foundation “Walk to Cure Diabetes” Team Captain, 2000 & 2001

American Diabetes Association Tour de Cure Team Captain, 2002 & 2003

Big Bear’s Hike for Diabetes Team Captain, 2000, 2001, 2002 & 2003



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