Clinical Services Coordinator Resume
Summary : Seeking a position Clinical Services Coordinator that utilizes skills, education, and experience and provides opportunity for career growth and development.
Skills : Phlebotomy, CPR, Emergency Medical Technician, Spanish Medical Terminology, First Responder Haz Mat.
- Entered all clinical data and relevant blood work information on every patient into the computer system.
- Followed-up on all in house pending results that were outside of the turn-around-time.
- Quality-assured all reports signed out by hematopathologists and sent reports to ordering physician's office.
- Distributed slides to ordering physicians, assisted physicians with any concerns.
- Monitored all reference laboratories to ensure appropriate turnaround time.
- Traveled to physician's offices throughout the country to perform bone marrow smear preparation presentations.
- Assisted clients with sending specimens to Genoptix Laboratories and addressed any concerns they had.
Sr. Clinical Services Coordinator Resume
Headline : Clinical Coordinator manages, directs and coordinates the operations of all Blood Banks across the Centra system. Evaluates and supports the pathologists and medical staff.
Skills : Medical Supervisor, Medical Assistant.
- Responsible for acquiring approval for treatment.
- Initiates and maintains all Prior Authorization packets on each patient regarding CHMS/RSPMI.
- Reviews and submits all PA requests to VO and AFMC.
- Receives all therapy evaluations and monitors re-evaluations.
- Maintains an evaluation tracking for each child in the clinic.
- Notifies all clinical staff of all updated evaluations and meetings.
- Reviews each patients chart every 90 days.
- Issues deficiency sheets as needed and ensures that they are corrected.
Jr. Clinical Services Coordinator Resume
Objective : Looking to take current skills in Clinical Services Coordinator and past skills as a Leader, and utilize them as a Leader in the Ambulatory or Acute Care setting. Reimbursement is critical to the success of any healthcare organization. Maintaining the balance between appropriate visits, safe discharge planning, and proper documentation is needed to make that happen.
Skills : Case Management, Utilization Review Nurse, Discharge Planning.
- Oversee all clinical operations for a multi-specialty clinic.
- Managed 24 employees including CMA, LPN, RN, Lab and Rad staff.
- Maintained all regulatory practices.
- Worked with staff on how to case manage their provider's practice.
- Reviewed charts for documentation requirements to avoid any payment concerns.
- Proper coaching and empowering staff to take of concerns on their own led to a sense of accomplishment for both them and myself.
- Used A leadership style that was different for each person.
Clinical Services Coordinator III Resume
Summary : To build a career in an ever-growing firm that will give great opportunities to display skills and experience in such a way to add more value to the organization and increase knowledge in the medical field.
Skills : Social Work, Retail, Human Services, Pharmacy Technicial.
- Collect clinical data and process referral authorization requests.
- Constant communication with Providers, IPA's, Medical Groups.
- Verify member's Benefits and Eligibility prior to processing authorization.
- Process Extensions and Denial Letters.
- Acquire supporting documents from IPA's and Medical Groups as requested from clinical nurse.
- Identify non-contracted providers and request Letter of Agreements.
- Authorize selected services per explicit criteria and guidelines.
- Obtain pre-certifications from health plans.
- Maintain confidentiality of member's information- HIPAA certified.
Clinical Services Coordinator II Resume
Summary : Seeking a challenging position where Clinical Services Coordinator experience will be fully utilized and expanded upon. Provider clinical appeals, including information follow up.
Skills : Abilities 65 wpm, Microsoft Outlook, Budgeting.
- Provider education and assistance for Outlier Process.
- Responsible for maintaining Outlier and Concurrent Queues.
- Complete incoming weekly reports- SCA, High-Volume Auth, Multiple Times A Week.
- Assist Clinical Care Managers with various administrative duties.
- Maintain Review Team clinical voice mail.
- Responsible for Outpatient Outlier Clinical Review Team.
- Organize correspondence, meetings, travel arrangements and daily calendar for Chief Medical Officer and staff.
- Review and follow-up of information submitted, processing fees, completion of forms, review of provider contracts to ensure accuracy and detail.
Asst. Clinical Services Coordinator Resume
Objective : Providing Clinical Services Coordinator experience and detail oriented problem solving skills to a dynamic healthcare organization. With combined professional experience in Education, Electronic Healthcare Records, Customer Service, and employee management.
Skills : Psychology, Client Services, Clinical.
- Efficiently coordinated and facilitated daily conference calls navigating very busy schedules.
- Audit and mentor team members continually.
- Client reporting, analysis, volume, and workflow assessment.
- Manage to 2-24 hour turnaround of presented client volume each day.
- Troubleshoot technical difficulties and provide online support to Account Reps.
- Work directly with Account Managers as a liaison between departments.
- React to daily needs that cannot be anticipated.
Clinical Services Coordinator I Resume
Objective : Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services requested. Prepare response letters for member and provider clinical appeals and ensure letters.
Skills : Microsoft Word, Excel, Powerpoint programs; Proficient typist.
- Responsible for the development and administration of departmental policy and operations.
- Preparation for an application of Behavioral Health Care Accreditation through The Joint Commission.
- Provided education for the College of Medicine Residents, Medical Students.
- Including the development of motivational interviewing skills, biopsychosocial assessment, community resources, coordination of care with interdisciplinary teams.
- Review and analysis of the utilization of services, provided by the Department of Psychiatry, to ensure adequate staffing.
- Review of data to identify and implement performance improvement activities.
- Interviewed candidates for the Psychiatry Residency program.
Master Of Social Work
Lead Clinical Services Coordinator Resume
Headline : Over 24 years experience in the medical industry as an RN with excellent communication, clinical, and teaching skills. Career change within the medical industry as a Certified Phlebotomist.
Skills : Certified Hospice and Palliative Care Nurse, Certified American Red Cross.
- Worked directly with the Trainer to ensure quality training of supervisor and line-staff.
- Chaired Staffings and Treatment Team Meetings weekly.
- Participated in IEP's as the Designated Surrogate Parent.
- Provided individual and conjoint sessions as needed.
- Ensured that intake psychological and ongoing psychiatric evaluations were provided.
- Interfaced with the Planned Activities Dept.
- Provided in-service training for NPS personnel.
Associate Clinical Services Coordinator Resume
Headline : A highly passionate Clinical Services Coordinator with experience working with individuals involved in crisis, those suffering with substance abuse and co-occurring disorders and people who are marginalized; providing support to enable clients to help themselves; acting as a guide and advocate.
Skills : Proficient in Microsoft Office Suite, and H/P 17B calculator.
- Coordinate with Medical Directors to clarify medical determinations or clinical rationale.
- Maintain current knowledge of NCQA and State regulations.
- Coordinate Fair Hearings with various internal departments and agencies.
- Facilitate training, auditing, and escalations, and assist with policy and procedure reviews and implementation of new processes.
- Prepare monthly, quarterly, and annual reports for denials and/or appeals.
- Coordinate workflows in the department and time-off requests to ensure proper coverage.
- Provided assistance to WorkCare Clinicians in case follow-up, clinic visitations, medical records, and case notes.
Clinical Services Coordinator Resume
Summary : Clinical Services Coordinator with Highly skilled career professional with more than 23 years practical experience in hospital and primary care environments. Coordinates the day to day business office operations of all the rehabilitation services locations including scheduling of patients
Skills : Microsoft Office, Disaster Recovery.
- Researched state-specific and federal regulatory requirements for home health agencies in order to support regulatory compliance.
- Assisted in the creation and revision of policies and procedures.
- Edited and revised Home Health and Hospice forms using Adobe Acrobat Pro.
- Updated and maintained the Clinical Services site using Microsoft SharePoint.
- Served as an organizational resource to Home Health and Hospice agencies undergoing State or ACHC surveys for Initial Licensure, Medicare recertification, validation, or due to a complaint.
- Conducted monthly Policy and Procedure Committee meeting and compiled reports for Governing Body Approval.
- Corresponded with company's major print vendors regarding updates to Policy and Procedure manuals and Agency forms.
- Managed the Denials and Appeals Log and ran reports utilizing Pivot Tables.
B.S. In Microbiology