A Medical Analyst takes charge of evaluating medical data to improve the business part of hospitals and medical facilities. These professionals carry out the following duties mentioned on the Medical Analyst Resume – investigating and reviewing medical records, discussing records with new clients, ensuring records are accurate and complete, developing and implementing record-keeping procedures, preparing accurate reports on the latest trends in customer service, researching and evaluating data from different sources to identify discrepancies; presenting and explaining status reports to management, performing regular site visits to evaluate operations and preparing policy guidelines, and petitions.
Those working at this capacity should be able to denote on the resume the following skills – excellent written and verbal communication skills, resourceful and highly analytical, a solid understanding of data management systems, healthcare products, and analysis tools, and strong knowledge of analysis tools. A bachelor’s degree in Health Information Systems or a relevant field is commonplace among job applicants.
Objective : Strong business and clinical experience in the health care industry with major focus on medical claim review, appeals, and data abstraction. Adept at research, project management, process development and problem solving. Exceptional verbal and written communication skills. Flexible, detail oriented and able to perform with little supervision.
Skills : Strong knowledge of data management systems and analysis tools.
Description :
Conducted local abuse and fraud investigations, assisted in multi-site investigations, coordinated the abuse and fraud detection program and implemented a provider coding accuracy and appropriateness program.
Educated the Provider Relations and Customer Service departments about the implemented programs.
Uncovered a deceptive billing scheme utilizing data analysis, medical record review and research of the provider's promotional materials.
Resulted in the suspension of claim payment for this specific provider.
Conducted two focus studies that uncovered claim payment errors and contracting improvement opportunities.
Improved hospital contracts and a claim-auditing department were established.
Performed physician quality-of-care investigations as a follow-up to quality referrals.
Experience
2-5 Years
Level
Junior
Education
Associate Of Science
Medical Analyst Resume
Headline : Organizing project tasks, structures information collection activities, and sets timelines for completion of required tasks, and also Developing reports on analysis conducted, provide recommendations, and makes formal presentations to communicate results to various management levels.
Skills : Microsoft Office Excel, Powepoint, Word, ISI Tool Box.
Description :
Investigated, evaluated, negotiated and equitably settled all assigned property/theft claim cases in accordance with company policies and procedures.
Verified and analyzed information, statements and records to determine if a questionable claim deemed suspicious and fraudulent.
Resolved suspicious claim by establishing scope, timing, and direction of investigations Interviewing witnesses, claimants and insured's Taking recorded statements.
Prepared claims for Examinations Under Oath (EUO), collecting police reports, recording evidence, analyzing records/information and communicating results to all relevant parties.
Inspected private homes, take photos, draw measurements and diagrams of the damages.
Determined proper policy coverage.
Trained new hires and created effective business manuals to enhance productivity.
Experience
5-7 Years
Level
Executive
Education
Masters Of Science
Medical Analyst Resume
Summary : Building and lead quality-focused teams committed to service excellence High-Touch, Service-Oriented Care Improve outcomes through identification of best practices Unique depth and breadth of experience within the healthcare field, supporting lean and cost-effective operations, establishing and meeting performance metrics, and creating environments committed to compliance and service excellence.
Skills : Electronic Medical Records, Microsoft Office, Payment Posting, Medical Billing, Medical Coding, Medical Receptionist.
Description :
Reviewed, analyzed, investigated and summarized medical records of injured party.
Prepared medical work product/chronology for use by case team.
Identified and assisted in developing medical and scientific defense expert witnesses for complex product liability litigation.
Prepared discovery deposition, as well as, trial direct and cross outlines of fact, scientific and medical expert witnesses.
Coordinated scheduling of CME/IME with expert and Plaintiff counsel, including scheduling of court reporter and obtaining advanced retainer.
Assisted expert in preparation for CME/IME.
Provided onsite trial support.
Experience
7-10 Years
Level
Management
Education
MS
Medical Analyst Resume
Summary : Highly qualified Medical Analyst with experience in the industry. Enjoy creative problem solving and getting exposure to multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Remote Medical Record Reviewer, Healthcare.
Description :
Transferred to coding department where I review claims for coding accuracy.
Priored to transferring to the coding department I was team lead of the specialty groups where my responsibilities were: Provide staff with up-to-date responses pertaining to changes in insurance industry.
Identified trends in rejections from insurance companies.
Trained new employees on computer system and policy and procedure.
Worked with staff to effectively increase productivity.
Trained passed their computer test first time they took it.
Trained staff most effective way to work their aging.
Experience
10+ Years
Level
Senior
Education
Bachelor Of Science
Medical Analyst Resume
Objective : Committed and motivated worker with exceptional customer service and decision-making skills. Strong work ethic, professional demeanor, and great initiative. Proficient at quickly learning new procedures.
Received medical records and filing them properly into electronic charts.
Gathered all OB patients charts and fax them to admitting at HRMC.
Handled medical record request forms, and properly disbursing correct medical information.
Properly routed phone calls to doctors, MA's, and nurses.
Taken payments throughout the day.
Experience
2-5 Years
Level
Junior
Education
MS
Medical Analyst Resume
Headline : Professional Medical Analyst with extensive experience in patient care, quality improvement, nursing education, and patient education. Progressive career growth demonstrating skills and experience in leadership roles, clinical consulting, as well as risk management (post-market quality), and design validation for medical devices/drugs in global healthcare industry.
Skills : Microsoft Office Products CMS Database Management Power Trak.
Description :
Presented A company who offers a variety of insurance products to all segments of the population including large employer groups, small businesses, and individuals.
Managed finances for determination of next steps using company processes.
Used Critical thinking and problem solving skills to raise awareness to potential risk/issues.
Managed customer service calls and ensure completion within required timeframe.
Managed and facilitated appeal processes with all third parties.
Researched and audited on all accounts, record information and document all explanations of benefits.
Communicated with insurance companies and hospitals for payments on medical claims.
Experience
5-7 Years
Level
Executive
Education
Associates In Health Science
Medical Analyst Resume
Headline : A Medical Analyst position in a results-oriented company that seeks an ambitious and career-conscious person, where acquired skills and education will be utilized toward growth and advancement.
Skills : Microsoft Office, Medical Terminology, Medical Billing, Medical.
Description :
Responsible for 7 different hospitals in Palm Beach County.
Reviewed census with lead physicians for potential updates.
Faxed lead physicians specialized excel census for their reference.
Admitted and discharged patients from the database.
Input all information for each patient's admission as obtained through hospital systems.
Verified insurance information and update via health plan.
Generated daily and monthly reports Retrieve clinical information Providing services to home health agencies with obtaining information From our physicians and/or company.
Experience
5-7 Years
Level
Executive
Education
Bachelor Of Science
Medical Analyst Resume
Headline : Responsible for Demonstrating initiative in identifying alternative solutions to issues in the project or department that are reasonably complex and require an understanding of how the outcome will affect multiple areas/departments.
Designed and ran multiple Provider reports crossing multiple systems, including extensive MS-SQL development, Oracle development, Access, multiple web applications, VBA macro programming, Excel, and Sharepoint.
Participated and contributed to numerous local and national committee projects, including PCP and specialist optimization, Plan optimization, Provider directory cleanup, Clinical IT system development such as Carebook and CGX, Member Attribution cleanup, provider directories and attribution cleanup, Dual Medicare - Medicaid plan enrollment projects, and the Medicaid HEDIS Pilot.
Worked with directors from every department, and with the regional VP, on numerous ad-hoc and report development requests.
Assisted co-workers in retrieving information from facilities that they may not be able to access.
Crossed coverage in all areas.
Ensured all patients are properly covered by their insurance companies before coming into their appointments.
Identified computer issues and completed plan of action to resolve.
Experience
5-7 Years
Level
Executive
Education
Master's
Medical Analyst Resume
Summary : Assisting in assessing workforce needs resulting from project implementation, and also Assisting in identifying and developing performance management and training tools.
Skills : Medical Billing, Front Office, Customer Service, Cashier.
Description :
Answered telephones, and direct calls to appropriate staff.
Used oral and written communication techniques.
Released information to persons and agencies according to regulations.
Used knowledge of medical terminology.
Planned, developed, maintained and operated a variety of health record indexes and storage and retrieval systems to collect, classify, store and analyze information.
Protected the security of medical records to ensure that confidentiality is maintained.
Reviewed records for completeness, accuracy and compliance with regulations.
Experience
10+ Years
Level
Senior
Education
Associate In Applied Science
Medical Analyst Resume
Summary : Responsible for Developing reports/dashboards and train others on the use of a specific analytics platform (i.e. Tableau, PowerChart analytics), including coaching about the appropriate procedure available within the platform that will most effectively address a specific problem.
Skills : Microsoft, Internet Explorer, Healthcare Worker.
Description :
Responsible for coding the Outpatient Services at our hospital and after I am done coding them I use a entry system to officially drop them so that the insurance billers can bill for the patrons services.
Made sure all my work is done in a timely manor so that all services are billed within a timely manor.
Made sure all billers are kept in work and have there questions answered in a timely fashion so as all claims are filed within the time frame allowed by insurance companies.
Used a copier and I have to answer questions that pertain to the medical field for pre-authorization into the hospital.
Reduced the number of days in aging.
Experienced in product-liability, pharmaceutical, medical device and tort litigation.
Provided administrative support including interviewing medical and scientific analyst candidates, facilitating caseload distribution, and assisting with training of newly hired analysts.
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