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Fidelis Care - Medical Management Associate Resume Example

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Jonathan Evans
XX XXXXX XXXXXX , Tonawanda , NY 14223 | (H) XXXXXXXXXX | XXXXXXXXXXXXXXXXXXX
Professional Summary

Licensed Practical Nurse with advanced knowledge of insurance policies, medical terminology ad HIPPA compliance.  Excited and driven with an established experience in several areas of the healthcare field.  Track record of initiative and achievement – seeking a position of responsibility within chosen field and expanding personal skill set.


Skills
  • Facets (CPT, HCPC, ICD-9)
  • Microsoft Office tools (Word, Excel, Power Point)
  • Identifies and gathers appropriate resources, thoroughly researches
  • Critical Problem solver, skilled in conflict resolution.
  • Makes and implements decisions, with adherence to policies.
  • Demonstrated talent for identifying, improving, and streamlining complex work processes.
  • Task Oriented and strong time management and organizational skills .
Experience
Medical Management Associate 03/2012 to Present
Fidelis Care Getzville, NY

Organize and maintain fax authorization requests for processing.

Review and input provider requests for service authorization.

Department wide updating of changes in policies and procedures.

Training staff in the authorization process and systems.

Trend Identifying through investigation of provider requests and claims.

Accurately track numbers and production for review

Assisting with multiple inter-departmental jobs.

Communicate with providers and members about authorization, eligibility status and company policies and procedure.

Maintain strict state and company compliance standards for timeframes and authorization determinations.

Promote open communication between other departments to facilitate an efficient and accurate work flow.



Professional Staffing Agency 10/2011 to 03/2012
AP Professionals Williamsville, NY

-Fidelis Care / Medical Management Associate

Received and identified incoming clinical information via fax

and distributed requests to corresponding departments.

Processed inbound fax requests following departmental workflows and guide lines.

-Univera Healthcare / Medicare Customer Service

Received incoming calls from Medicare member regarding plan policies and procedures.

Provided quality service to members while working efficiently in a fast paced environment

















Education
Licensing: Practical Nursing Jul 2011 Madison-Oneida BOCES - Verona , NY
Certification: Medical Billing and Coding Bryant & Stratton - Getzville, NY
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Resume Details

This is a real resume for a Medical Management Associate in Tonawanda, New York with experience working for such companies as Fidelis Care, Ap Professionals. This is one of the hundreds of Medical Management Associate resumes available on our site for free. Use these resumes as templates to get help creating the best Medical Management Associate resume.

Previous Companies:

  • Fidelis Care
  • AP Professionals

Previous Job Positions:

  • Medical Management Associate
  • Professional Staffing Agency

Schools:

  • Madison-Oneida BOCES
  • Bryant & Stratton

Level of Education:

  • Licensing
  • Certification

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