SUMMARY

• Driven health care professional with 6 years of experience supporting both public and private sector clients with healthcare delivery operations and implementations.
• Ms. Confidential has supported and led a wide variety of cross - disciplinary projects leveraging her project management expertise, interpersonal skills and advanced knowledge of various database and system.
• Her diverse breadth of industry experience combined with her advance degree in health sciences results in strategic and tactical delivery of high quality results, which drive change.

• Healthcare Administration
• Health Informatics
• Helpdesk operations
• Project Management
• Medical Coding
• Health Insurance
• Data Visualization
• GE Centricity
• Electronic Medical Records
• Electronic Health Records
• Gap & Workflow Analysis
• Research Methodologies

PROFESSIONAL EXPERIENCE

Confidential, Washington, DC

Healthcare Consultant

Responsibilities:

• Develop rich understanding of the client’s business objectives accurate to ensure successful project implementation
• Provide subject matter expertise related to claims billing, coding and reimbursement policies and procedures
• Develop and maintain documents and/or deliverables for program management
• Collaborated with business units to assess potential project impacts and critical success factors
• Effectively utilize stakeholder relationship management and project management principles to support an enterprise-wide transformation of a healthcare delivery system

Confidential, Baltimore, MD

Quality Improvement Data Analyst

Responsibilities:

• Conduct data exploration exercises using a variety of complex business intelligence tools
• Compile and present data, for a variety of end users, into formats including excel dashboards, access databases and executive briefings
• Perform a variety of analytics services, leveraging expertise in the areas of data analysis, clinical care, process re-engineering, to help uncover trends and patterns to support workflow changes
• Utilized my thorough understanding of healthcare to support their hospitals with operational readiness for healthcare reform programs such as value-based purchasing, Meaning Use, and other pay for performance programs.

Confidential, Columbia, MD

Supervisor, Provider Data

Responsibilities:

• Oversaw the daily work of a team consisting of more than 15 individual contributors
• Improved databases by leading effort to automate claims processes and other alterations basedn process, information, and regulation changes
• Accurately utilizes database and system tools to enter and research provider data, including SalesForce, Microsoft Excel, Microsoft Access, Facets and Convey
• Researched, collected, and organized data in order to answer specific business questions
• Participated in the development of rules and procedures in support of regulatory requirements
• Led and contributed to various projects related to the analysis and reporting of provider data

Confidential, Elkridge, MD

Health Informatics Analyst

Responsibilities:

• Performed a variety of services for federal clients, leveraging expertise in the areas of program management, data analysis, clinical care, analytics, and process re-engineering
• Delivered appropriate solutions based on in-depth research and comprehensive analysis
• Participated in the creation and implementation of support and functional documentation
• Established stream of communication with end users, clients, and federal stakeholders

Confidential

Informal Review Analyst

Responsibilities:

• Thoroughly reviewed Informal Review (IR) requests submitted by eligible professionals
• Developed and disseminated resolution correspondence on the behalf of federal clients
• Partnered with clinical and methodological experts for consultation on various assignments

Confidential, Annapolis, MD

Clinical Assistant

Responsibilities:

• Provided quality care to patients, assisting them with cardiac tests and studies
• Obtained vital signs, and gathered patients’ medical histories before tests were performed
• Educated patients regarding procedures, tests results, and their general health and care
• Managed prescription refill requests, and stocked exam rooms with necessary supplies
• Updated Electronic Medical Record (EMR) with medical history, test results, and progress

Confidential, Annapolis, MD

COBRA/FSA Specialist

Responsibilities:

• Managed COBRA claims, which included processing FSA claims and card transactions
• Prepared monthly COBRA invoices, and posted COBRA premium payments to accounts
• Processed FSA and COBRA participant inquiries, and responded to eligibility questions
• Coordinated monthly changes to enrollment for participating COBRA patents
• Maintained accurate files on COBRA applications, premiums, and lapse dates
• Reviewed medical, vision, and dental claims in accordance with contractual agreements
• Gathered information from providers and plan participants to make accurate determinations
• Ensured efficient workflow by updating inventory of claims, and followed up on pending claims
• Responded to provider and member inquiries regarding claim payments and denials

Confidential, Odenton, MD

Certified Medical Assistant

Responsibilities:

• Provided support to doctors during exams and minor surgeries, and delivered care to patients
• Obtained medical histories, and recorded primary complaints associated with patient visit
• Measured and recorded vital signs and collected and prepared lab specimens for testing
• Scheduled and organized appointments for patients using IDX Scheduler software
• Responded to questions from patients and families regarding procedures that were performed
• Maintained accurate records of care and progress and updated EMR with new information

Confidential, Columbia, MD

Front Desk Associate

Responsibilities:

• Verified health insurance coverage prior to appointments and reviewed billing documents