Health Care Specialist Resume Samples
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Health Care Specialist Resume Samples
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YF
Y Friesen
Yasmin
Friesen
216 Pouros Roads
New York
NY
+1 (555) 625 4033
216 Pouros Roads
New York
NY
Phone
p
+1 (555) 625 4033
Experience
Experience
Dallas, TX
Health Care Claims Specialist
Dallas, TX
Stark Group
Dallas, TX
Health Care Claims Specialist
- Meet or exceed production and quality standards for processing
- May be responsible for mentoring newer associates
- Research, resolve, and respond to inquiries and problems of a moderately complex nature
- Adjudicate claims in moderate complexity categories
- Route claims that cannot be finalized
- Follow documented policies and procedures
- Knowledge of CPT, ICD-9, and HCPCS codes
Chicago, IL
Account Sales Specialist Home Health Care
Chicago, IL
Metz, Nicolas and Rutherford
Chicago, IL
Account Sales Specialist Home Health Care
- Assist in crafting strategy and customer communications, developing use case, and leveraging market knowledge for sales opportunities
- Provide continuous feedback to product and marketing teams and participate in projects to help marketing in meeting strategic sales objectives
- Assist in rolling out and monitoring product trials to maximize effectiveness
- Prospect & qualify leads to develop new business opportunities
- Execute new business sales strategies
- Manage the complete sales process through contract execution
- Perform effective product demonstrations of the Home Health Solutions
present
Dallas, TX
Health Care Coodinator / Medical Specialist
Dallas, TX
Ebert, Daniel and Pfannerstill
present
Dallas, TX
Health Care Coodinator / Medical Specialist
present
- Assist the field-based house calls team with moving the patient through the continuum of care by communicating with and completing tasks as directed
- Demonstrate exceptional two-way communication using clear and well-organized oral and written techniques
- Act in accordance with the DaVita, Inc. mission and values to deliver high quality care to our patients
- Maintain accurate and complete documentation of records. Forms are fully-completed, legible, have no unapproved abbreviations and have the proper signatures
- Assist the care management staff with implementation and documentation of the discharge care plan that includes initiation of referral forms, gathering clinical information, initiating the process of completing a chart and appointment scheduling
- Other duties as assigned
- Proficiency with Microsoft Office
Education
Education
Master’s Degree in Healthcare
Master’s Degree in Healthcare
Ashford University
Master’s Degree in Healthcare
Skills
Skills
- Knowledge of applicable state, and federal regulations
- Excellent organizational skills with the ability to manage multiple priorities
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
- Ability to abide by Molina's policies
- Conduct self in a professional manner at all times
- Excellent verbal and written communication skills
- Conducts “inter-rater reliability” on an annual basis
- Ability to take initiative and see tasks to completion
- Implement training and mentoring for new staff and new system / process training
- Familiar with NCQA, Interqual and Molina Guidelines and Processes
14 Health Care Specialist resume templates
Read our complete resume writing guides
1
Health Care IT Applications Specialist Resume Examples & Samples
- In-depth knowledge of optimal workflow and clinical requirements within the Radiology clinical areas
- Coordinate and deliver first class training. Ensure post training reports are completed
- Create quality training material for customers as required
- Supporting the sale of GEHC products to the medical community by assisting the field Sales representatives with pre-sale demonstrations
- Strong analytical and problem solving skills required
- Ability to work to defined goals and deadlines
- Motivated, self-directed individual who can embrace a fast-paced, dynamic business environment
- Possess strong customer management skills and the ability to work in high-pressure environments
- Requirement to work to a high level of defined values and ethics
- Candidate should have experience in a clinical/patient care environment and Radiology experience is desirable
- Ability to operate a PC and use Windows based software, essential
- Must have a valid driver's license as travel is essential. This is a home based role however up to 80% travel can be expected. Applicants can be required to work weekends/ evenings to meet the demands of the business
- Establishes and maintain excellent relationships with customers and colleagues
- Shares expertise and knowledge with others
- Gives presentations with skill and confidence
- Responds quickly to the needs of an audience and to their reactions and feedback
- Ability to flex interpersonal style
- Shows imagination and courage in order to identify development strategies needed to achieve career goals and meet new or changing demands of the job
- Has an awareness of current developments within the market
2
Clinical Care Specialist Population Health Mgmt Resume Examples & Samples
- Self-directed and able to organize and manage multiple tasks/projects simultaneously
- Ability to promote programs and services to community
- Proficient in review of medical records and other patient care information
- Strong computer skills and abilities
- Demonstrated skills in verbal and written communication
- Ability to promote and build teamwork and multidisciplinary care concept
3
Account Sales Specialist Home Health Care Resume Examples & Samples
- Execute new business sales strategies
- Build relationships with prospects, partners and customers
- Prospect & qualify leads to develop new business opportunities
- Assist in rolling out and monitoring product trials to maximize effectiveness
- Manage the complete sales process through contract execution
- Deliver on Cross Promotional Product Strategies with other Clinical Solutions product teams
- Perform effective product demonstrations of the Home Health Solutions
- Motivate, train, focus and coordinate the activities of the other sales channels to drive Home Health/Long Term Care sales
- Serve as Home Health /LTC specialists for other sales team channels
- Assist in crafting strategy and customer communications, developing use case, and leveraging market knowledge for sales opportunities
- Key expert on the competitor: knows everything about the competitors’ business, strategy and sales approach in territory
- Provide continuous feedback to product and marketing teams and participate in projects to help marketing in meeting strategic sales objectives
- Channel feedback to the Product organization for continued product enhancement and new development needs, including for customized solutions
- This is a home based position requiring 40-50% overnight travel
- Utilize Sales Standards and Tools (Sales Framework, Siebel CRM)
4
Senior Health Care Claims Specialist Resume Examples & Samples
- Adjudication of complex claims, including claims involving hospital inpatient bills, Coordination of Benefits, co-surgeons, multiple surgical procedures, dual entitled members, adjustments, worker's compensation, or motor vehicle accidents
- Respond to client inquiries and process adjustments for all claim types in a timely and efficient manner
- Interact periodically with the client
- Responsible for providing guidance and mentoring to less experienced associates, but will have no formal supervisory responsibility
5
Senior Health Care Claims Specialist Resume Examples & Samples
- Analyze and adjudicate complex hospital and medical claims
- Respond to client inquiries and process adjustments for all claim types in a timely and efficient manner. This may involve direct client contact
- 3 years of medical and facility claims processing experience
6
Health Care Claims Specialist Resume Examples & Samples
- Follow documented policies and procedures
- Research, resolve, and respond to inquiries and problems of a moderately complex nature
- Knowledge of CPT, ICD-9, and HCPCS codes
7
SSD Senior Health Care Systems Specialist Resume Examples & Samples
- Assesses training modality & content for upcoming new functionality releases
- Conducts analysis of client business processes and functional requirements and prepares appropriate documentation to communicate and validate the information
- Supports the implementation of initiatives into deployment using project management methodologies
- Perform predetermined work in system as defined by policy and procedure/protocol
- Leads the coordination of solution development and supports implementation of initiatives into deployment using project management methodologies
- Minimum four (4) years of experience in information systems analysis or implementation or Healthcare operations (Master's Degree in related field (see Education/License/Certification) can be used in lieu of one (1) year of experience)
- Master's degree in healthcare, information systems, computer science, engineering or related fields OR six (6) years of directly related experience preferred
- Knowledge in health care, clinical systems, information systems, or other related field
8
SSD Health Care Systems Specialist Resume Examples & Samples
- Assist with application technical and operational knowledge in the analysis of client requirements in project areas such as
- Assist in cross functional task forces to identify and document functional requirements, workflow, information sources and distribution paths
- Conducts analysis of client business processes and functional requirements and prepares appropriate documentation to communicate and validate the analysis with clients and/or more senior level staff
- Assist in the analysis and definition of efficient, cost effective solutions which support client business processes and functional requirements
- Assist as a support for the implementation of initiatives into deployment using project management methodologies
- Serve as a single point of contact for the resolution of client issues and acts as a liaison between business clients and IT technical staff
- Assist in development of product enhancement requests
- Epic experience highly preferred: Cadence, Welcome, Prelude, Resolute billing, Tapestry or Security
9
Health Care Coodinator / Medical Specialist Resume Examples & Samples
- Assist the care management staff with implementation and documentation of the discharge care plan that includes initiation of referral forms, gathering clinical information, initiating the process of completing a chart and appointment scheduling
- Communicate directly with patients on a timely basis for all scheduling requirements
- At least two years of experience in a medical office or hospital setting
- Knowledge of medical terminology, HIPPA procedures, and experience working in patient care settings
- Ability to adjust quickly and effectively to changing conditions and demands when performing assignments in order to meet Department and Regional goals
10
SSD Health Care Systems Specialist Resume Examples & Samples
- Assist with application technical and operational knowledge in the analysis of client requirements in project areas such as: IT testing and product acceptance, gap analysis, development of new business operating models with innovative approaches to IT solutions support and available product functionality, operational readiness assessment, and others
- Conducts and approves analysis of client business processes and functional requirements, and prepares/approves documentation to communicate and validate the information with clients at various levels
- Assist in and approves the analysis and definition of efficient, cost effective solutions which support client business processes and functional requirements
- Assist in and approves the development of comprehensive business cases with cost, service, and benefit dimensions of proposed IT projects that are used at various levels for funding and scope decisions
- Provide leadership in supporting the implementation of initiatives into deployment using project management methodologies
- Develops and/or approves test&activation support plans, business requirement documents, and works with client to perform cross functional risk assessment
- Leads the coordination of solution development and oversees implementation of initiatives into deployment using project management methodologies
- Serve as a single point of contact for the escalation and resolution of client issues and acts as a liaison between business clients and IT technical staff
- Evaluate existing application products which could address client requirements and develop/approve recommendations where appropriate
- Lead the coordination of solution development and supports implementation of initiatives into deployment using project management methodologies
- Completes and oversees administrative requirements in an accurate and timely manner (e.g. time reporting, status reporting, etc.)
- Minimum six (6) years of experience in information systems analysis or implementation or Healthcare operations (Master's Degree in related field (see Education/License/ Certification) can be used in lieu of one (1) year of experience)
- Master's degree in health care, information systems, or computer science engineering is preferred
11
SSD Senior Health Care Sys Specialist Resume Examples & Samples
- Analyzes and defines efficient, cost effective solutions which support client business processes and functional requirements
- Perform systems configuration work
- Evaluate existing application products which could address client requirements and develop recommendations where appropriate
- Develops test & activation support plans and works with client to perform risk assessment
- Functions as a subject matter expert and can offer guidance and lend expertise to management and other team members
12
Epic-ssd Health Care Systems Specialist Resume Examples & Samples
- Analytical assessment of problem incidents for next higher level of support
- Minimum two (2) years of experience in information systems analysis or implementation or Healthcare operations (Master's degree in related field (see Education/License/ Certification) can be used in lieu of one (1) year of experience)
- Master's degree in healthcare, information systems, computer science, engineering or related fields OR six (6) years of experience in a directly related field preferred
- MS Office - Excel (Vlookup, formulas and functions), Access (Importing, Exporting, Queries) Word, Visio
13
Health Care Services Program Specialist Resume Examples & Samples
- Provide needed training programs and classes regarding systems and processes to improve and maintain staff knowledge base
- Implement training and mentoring for new staff and new system / process training
- Maintain compliance with training programs in conjunction with program requirements, and Federal and State regulations
- Assist with Quality Improvement Audits to assess Molina Healthcare Services staff system capabilities and educational needs
- Conducts “inter-rater reliability” on an annual basis
- Records and trends individual and department reviews results on weekly, monthly, quarterly and annualized basis
- Conduct self in a professional manner at all times
- Acts as an information systems problem solving resource for Molina Healthcare Services team members
- Familiar with NCQA, Interqual and Molina Guidelines and Processes
- Knowledge of state and federal regulatory requirements
- Superior computer skills and experienced user of Microsoft Office software
- Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers
14
Health Care Specialist Resume Examples & Samples
- Performs activities that relate to care coordination for multiple patient types (Inpatient Admissions, Outpatient Observation, Emergency), and patients at home or in Skilled Nursing Facilities including dissemination of patient information and support coverage of other health care departments or entities
- Responsible for phone calls/interviews with patient, family member and/or physician offices. Validates, obtains and enters demographic, clinical and insurance information into the Population Management patient tracking system. Utilizes multiple modes of communication (phone, fax, patient portal/e-mail, mail, etc.) and in a professional, accurate, efficient and courteous manner to obtain information and ensure good patient relations and a smooth care coordination process
- Provide outbound calls for follow-up appointment reminders to patients (pre and post follow ups) and assist in patients in scheduling who need assistance
- Education: Associate Degree
- Licensure/Certification preferred based on discipline: Exercise Physiology, Social Work or LPN recognized by the state of Ohio
- Minimum of two to three years' experience in patient care or related setting such as home health, clinic, ambulatory care center, medical call center, or physician office in which dealing with the public, assessment and critical decision-making skills are required
