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.
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.
-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
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.
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