Resume for a Houston Texas Healthcare Administration Project Manager

by Teneika Tillis
(Houston, TX)

Resume for a Houston Texas Healthcare Administration Project Manager

HEALTHCARE ADMINISTRATIVE:

Summary: I am qualified in the Healthcare and Administrative sectors with over 7 years’ experience. I encompass excellent computer skills, Medical terminology and knowledge of HCPCS and ICD-9 codes.

Skilled in Microsoft Office 7, medical management Software, and IDX claims system. I have managed a team of 13 people successfully while creating processes that helped the company excel in medical claims tracking thus resulting in a decrease in claims audits.

I have excellent Communication skills and interpersonal skills I will bring a great deal of professionalism and work ethic resulting in greater profits for the organization. I am a very dependable and punctual employee driven to excel at every job task given.

Professional Work History:
Healthcare Partners, Memphis, TN 03/2008-07/2011
Provider Contract Coordinator II/Project Management (08/2009-07/2011)

• Utilized knowledge for problem solving, communication and negotiation skills
• Tracked and monitored provider contracts.
• Coordinated projects
• Gathered and consolidated provider data from internal/external sources
• Resolved administrative problems by coordinating the preparation of reports, analyzed data and identified solutions

• Responded to correspondence and other communication in a professional and timely manner
• Coordinated, tracked and routed incoming Contracts /Credentialing/LOA, requested verification of provider information and initiated the contract process
• Gathered and consolidated provider data from a variety of internal and external sources

Document Imaging Reviewer/Claims (08/2008-08/2009)
• Logged claims into IDX claims system
• Managed multiple projects from initiation to completion
• Submitted daily inventory report to Claims Supervisor
• Established and maintained strong business relationships with internal and external customers
• Linked Medical records to claims in Macess system
• Developed and distributed PM inventory reports to the Manager and Supervisor
• Analyzed biweekly reports and provided updates to the Claims Manager
• Verified HCPC, ICD 9 and provider’s information

Claims Document Technician (03/2008-08/2008)
• Data entered claims into the Macess system
• Ensured HCPCS and IDX diagnosis were correct
• Corrected patient and physician information
• Logged paper claims into IDX system and generated claim numbers

Aetna US Healthcare, Memphis, TN 09/ 2003-12/2007
Claims Benefit Specialist
• Adjudicated HMO and Private Insurance Claims
• Processed Medicare and Medical claims
• Posted Payments into medical manager billing software
• Generated Accounts Receivables

Cedars Sinai Medical Center, Memphis, TN 08/1995-09/2002 Certified Nurse Assistant – PRN/ Patient Business Office
• Provided patient care Monitored vital signs
• Assisted with medical Procedures
• Admitted and Discharged patients
• Verified patients insurance
• Provided customer service to patients and families

2004-2008 Attended College Full Time

Education: United Education Institute, Memphis, TN
Technical Diploma

Professional Skills:
• Microsoft Word
• Microsoft Excel
• Knowledge of ICD-9 and HCPCS
• Microsoft Exchange
• Knowledge of Ub-92 and CMS 1500 forms
• Microsoft Visio
• Emptoris Web-based Software
• ICD9/CPT Coding
• Type 60-65 WPM
• Alpha/Numeric 12,000 keystrokes

**Interested Health Care management HR recruiters may contact this candidate via the COMMENTS hyperlink below this page.**