Clinical Representative Resume Sample
Sheila Ledner
31023 Gutkowski Mountains,
San Francisco,
CA
+1 (555) 711 6622
Work Experience
Senior Field Clinical Representative
08/2016
-
PRESENT
Philadelphia, PA
- Resolves and as applicable escalates Physician's office and client issues
- Uploads medical photographs into shared drive. Compiles case files on new referrals and distributes to assigned caseworker. Data entry of client information into the statewide Client Information System. Pays invoices and maintains expenditure spreadsheet. Orders office supplies for multiple office locations. Completes Office of the Attorney General clinical billing for the division
- Answers, screens and directs calls to appropriate CPT staff using a multi-line telephone system. Greets and routes clients, professionals and other visitors to the Child Protection Team. Access multiple outlook calendars and emails each calendar daily to designated recipients. Access and print intake reports for medical providers
- Assists with the processing of case closures working closely with Clinical Case Managers to relay findings and recommendations to the Department of Children and Families. Send referrals to UFCPT community partners daily
- Using personal computer and word processing software, creates, types and updates forms, labels and lists as needed. Replenishes supply of forms and labels as needed to ensure on-going availability. Copy, files, letters, forms, books, clinic notes and other materials needed for staff. Collates and distributes accordingly
- Greets patients in a friendly and professional manner, updates all demographic information and facilitates adherence to schedule of appointments
- Registers patients accurately ensuring all pertinent data is obtained and entered in the IDX system and updates all other registration areas
Clinical Service Representative
01/2012
-
02/2016
San Francisco, CA
- Verifies insurances through Eligibility system and/or Navinet
- Performs all end of day procedures including batch proof and credit card settlements
- Schedules all special appointments such as Medical Students and Women’s Health procedures
- Serves as back up for referrals and precertifications
- Maintains accurate records in IDX to meet the needs of the department, following established guidelines
- Collaborates with genetic counselors and clinical nutritionists on necessary requirements to schedule patients from referrals. Gather and verify patient information including demographics and insurance information with referring physician office
- Patient Scheduling: Schedule appointments including referral scheduling and pre and post-clinic visitations. Under faculty and clinical staff direction, schedule special patients, such as physician-directed clinic bumps. Uses the electronic medical records system, EPIC, to post communication messages to the genetic counselors, clinical nutritionists, and physicians
- Triage issues and concerns to indicated areas, including team an triages issues and concerns to indicated areas, including team and Office Chief; Offices for SMI grievances and appeals; Human Rights; Individual and Family Affairs, including Adult and Children’s System of Care; quality management; fraud and abuse; and medical leadership
- Support clinical pre-authorization services team as follows
Clinical Site Development Representative
04/2007
-
08/2011
Detroit, MI
- Opening and closing procedures for office
- Greeting and checking in patients for appointments, verifying demographic and insurance information
- Obtaining consent and authorization for clinical care, procedures, and ancillary studies as needed
- Serving as the main telephone operator to schedule appointments, route calls, check voicemails, etc
- Keeping reception and waiting area neat and tidy
- Escalating issues to coverage determination clinical pharmacists and management team as needed
- Conducting outreach via phone or fax to process coverage requests, and obtain additional information needed to process requests
- Reading, analyzing, and interpreting general business correspondence, technical procedures, and governmental regulations
- Solving practical problems and dealing with a variety of concrete variables in standardized situations
Education
Amberton University
2001 - 2006
Bachelor's Degree in Science
Professional Skills
- Excellent communication, organization and problem-solving skills required
- Strong customer service skills, which reflect warmth, acceptance and respect towards a diverse patient population
- Exhibited proven leadership skills with consistently high performance ratings
- Team player with outstanding customer service skills
- Microsoft Word and Excel skills (to process letters, spreadsheets, labels, and other documents)
- Maintaining the integrity of the prior authorization system use for Medicare Part D Coverage Determinations and Appeals
- Three (3) years of experience in physician, hospital or health center billing setting, including management of various types of insurance billing processes
How to write Clinical Representative Resume
Clinical Representative role is responsible for excel, software, credit, training, reporting, research, insurance, travel, phlebotomy, word.
To write great resume for clinical representative job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Clinical Representative Resume
The section contact information is important in your clinical representative resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Clinical Representative Resume
The section work experience is an essential part of your clinical representative resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous clinical representative responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular clinical representative position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Clinical Representative resume experience can include:
- Direct, counsel, advise, and schedule patients seeking dental care at the CoD, both by telephone and in person. Discuss treatment and CoD and/or Faculty Practice policies and procedures. Coordinate treatment with dentists and dental assistants
- Excellent organizational, communication and problem-solving skills required
- Excellent organizational, communication and problem-solving skills required Schedule flexibility to meet business needs
- Extensive knowledge of and experience assisting with the surgical placement of dental implants, multiple implant systems, maintenance, and ordering needs
- Previous experience working in a Cardiac Catheterization (Cath) Lab and/or Electrophysiology (EP) Lab
- Experience with medical clinic appointment scheduling and medical records systems, UF student records system, Microsoft Office programs
Education on a Clinical Representative Resume
Make sure to make education a priority on your clinical representative resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your clinical representative experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Clinical Representative Resume
When listing skills on your clinical representative resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical clinical representative skills:
- Experience assisting with intravenous sedation including demonstrated experience in phlebotomy
- Communicate effectively in writing, by telephone, and in person
- Work effectively as a collaborative team member with a high a level of accountability and responsibility
- Ensures patients are registered and scheduled correctly and that patient accounts are validated prior to appointments
- Configuring utilization management requirements into the prior authorization system
- Scheduling patient appointments and obtaining prior dental records and studies
List of Typical Experience For a Clinical Representative Resume
1
Experience For Clinical Service Representative Resume
- Gathering and verifying patient information including demographics, insurance coverage, and financial status
- Working incoming cases via phone (primarily) or fax to process coverage requests from members or prescribers
- Completing contract support activities including: preparation of outreach letters and organization of contract materials
- Schedules appointments and tests as needed, including operating room scheduling and pre- and post-clinic visitations
- Accurately preparing high quality professional written correspondence and service documentation
- Responsible for meeting monthly enrollment goals
- Collect payments, makes follow-up appointments, and generate report of receipts and balances daily
- Respond to requests from dentists and faculty members regarding patients, scheduling, etc., and follow through to completion. Review, print, and call patients from Epic referral source. Obtain proper insurance authorizations for medical patients, while collaborating with a certified coder on any financial responsibilities for the patient are met
2
Experience For Clinical Site Development Representative Resume
- Verify and enter new patient demographics, confirm patients’ appointments, and see that all patients scheduled for medical treatment are verified and proper authorizations are in place
- Assist patients with accounting and insurance questions by reviewing treatment plans, progress notes, and accounting ledger information
- Maintain patient short-call list and uses information to fill schedule
- Provides direct, real-time phone triage, patient services and problem-resolution, including registration, scheduling, prescription refills, lab/imaging results, and phone triage with an emphasis on timely, seamless, patient-centered service within the context of the clinic-specific protocols and scripting
- Gathers and/or verifies patient information including demographics, insurance coverage and financial status. Uses e-Commerce, Medicaid Web Portal, and other online payer specific websites
- Prepares financial procedure quotes using the UFP system
- Following policy for accepting patients into clinic, provides excellent customer service, and informs perspective patients of procedures and eligibility requirements to become a clinic patient
- Answer incoming inquiries from UPMC Health Plan members and providers
3
Experience For Clinical Pre-authorization Representative Resume
- Attend offsite/onsite benefit fairs-interact with members and schedule appointments
- Complete initial review of all faxed material
- Conduct and document outbound calls to clarify, follow-up and resolve customer inquiries
- Conduct outbound member and provider calls in accordance with department initiatives and regulatory requirements
- Create cases in the authorization system when appropriate
4
Experience For Field Clinical Representative Resume
- Maintain strict confidentiality related to medical records
- Perform call backs to members/providers to supply authorization decisions
- Remain current on all department policies, procedures, plan benefit designs and modification
- Working incoming cases via phone (primarily) or fax to process coverage requests from members or prescribers - Conducting outreach to patients and providers, and obtaining additional information needed to process requests
- Initiates financial contracts for new patients
- Checks financial obligations to ensure they are current
- Contacts parent or patient regarding delinquent/past due accounts. Accepts and processes patient payments and sets up automatic account withdrawals using Virtual Merchant Software. Presents different fees and payment options to patients
- Works with the University of Florida College of Dentistry (UFCD) business office, the Medicaid office in Tallahassee, and the UFCD Children's Medical Service (CMS) liaison concerning patient accounts. Recommends and implements operating policies and procedures
- Responsible for maintaining records management of dental charts, including use of Dolphin and AxiUm software for chart tracking and editing patient information when changes occur in files. Keeps correspondence and forms accurate and current utilizing system features in Dolphin
5
Experience For Senior Field Clinical Representative Resume
- Ensures patient policies and procedures conform to legal and patient confidentiality requirements
- Coordinates all departmental CMS activity; maintains patient treatment information in electronic database; sends appropriate letters and records requesting funding for patients which requires in-depth knowledge of CMS policies and procedures; maintains file copy and tracks approval or disapproval; maintains communication with CMS college staff
- Interacts with faculty, residents, and students to ensure that patient records are provided daily and maintained to effectively support patient treatment programs
- Assists clinical staff and co-workers as needed regarding Epic, CPT and current ICD coding, e-Commerce, Medicaid Web Portal, and other online payer specific websites
- Customer service or call center experience required
- Initiating telephonic and email outreach to prospective KnovaSolutions members
- Knowledge of Clinical Operations required
6
Experience For Clinical Field Representative Resume
- Arranged Care – Schedules client appointments and consultations. Refers scheduling to CSRII, CSRIII or On-Call provider when appropriate. Obtains initial patient demographic information
- Dental receptionist experience
- Responsible for maintaining patient and newborn screening records
- Familiar with billing practices of Medicaid and medicare
- Proofread and check documents for accuracy, and maintaining confidential records
- Integrated Care – Inspects intake documentation for emergent concerns and refers to appropriate provider when necessary
- Transcription – As needed, perform transcription, dictation of the dermatopathology reports that are performed by the dermatopathologists. Input notes and dictation into the report in a Word format. File results of tests performed in the laboratory and pulls reports as needed for dermatopathology quality assurance
- Facilitate transportation needs
- Knowledge of clinic efficiency
7
Experience For Clinical Admissions Representative Resume
- Plan, organize, and perform work assignments
- Knowledge of dental procedures and nomenclature
- Knowledge of CoD patient policies and procedures
- Basic fundamentals of clinical practice operations
- Organize and maintain accurate files
- Work with diverse individuals with language and communication barriers
8
Experience For Representative, Senior Field Clinical Resume
- Biomedical educational focus
- Practices clinic efficiency
- Practices time management
- Preference for MA or LPN
- Certified Dental Assistant and Certified Dental Radiographer
9
Experience For Customer / Clinical Service Representative Resume
- Work independently and to organize and maintain patient records
- Knowledge of SHCC’s functions, policies and confidentiality procedures
- Evaluate problems and implement solutions, as well as compile and analyze data for administrative decisions
- Knowledge of IDX and Centricity EMR
- Exposure to EPIC and/or Titanium medical record systems with ability to maintain and manage confidential information in accordance with HIPAA regulations
- Follow verbal and written instructions and pay close attention to details
10
Experience For Representative, Clinical Payments Resume
- Initiate, follow-through on, and complete projects
- Come into physical contact with patients
- In a Boston Scientific clinical position
- Demonstrated ability to work as part of a highly-motivated team where flexibility and adaptability in a fast-paced, constantly changing work environment are paramount and urgency often dictates dynamic work schedule
- IBHRE or ability to obtain certification
- Reliable transportation and ability to travel (50%) within the United States as necessary.Ability and willingness to work evening and weekends and to travel overnight
List of Typical Skills For a Clinical Representative Resume
1
Skills For Clinical Service Representative Resume
- Two (2) years of experience in physician, hospital, or health center billing setting
- Experience in medical clinic appointment scheduling and medical records systems, UF Student Admin student records system, Microsoft Office programs
- At least two (2) years of relevant experience in a medical office setting
- Three years experience working in Behavioral Health or Psychiatry office
- Experience in Epic appointment scheduling system
- Customer service experience in a business office setting, preferably in a healthcare environment or call center environment required
- Knowledge or experience with computer programs for word processing and various computer software applications
- Practices good time management
- Knowledge and experience with computer generated appointment systems and Epic Electronic Health Record system
2
Skills For Clinical Site Development Representative Resume
- Multitask, prioritize responsibilities, problem solve, and function in a team environment
- Experience in a medical call center
- The ability to multi-task, prioritize responsibilities, problem solve and function in a team environment are necessary attributes of the successful incumbent
- Prioritize, plan, and organize work activities
- One (1) year of customer service or call center experience required
- Develop and maintain effective working relationships with clinical prevention service team members
- Identifying and collecting deductibles, co-payments, or deposits for services
- Inputting patient demographic, insurance, and registration information into Axium, the patient accounting system
- Verifying accuracy of demographic information and updating the patient transaction records
3
Skills For Clinical Pre-authorization Representative Resume
- Answering incoming calls from patients, dentists and other dental care providers (internal & external), etc
- Initiating and resolving coverage requests
- Entering all scheduling information into AXIUM system
- Providing registration forms, release forms, and other forms to patients for signature
- Explaining any necessary patient signature requirements
4
Skills For Field Clinical Representative Resume
- Ensuring proper insurance, discount, patient type codes, etc. are recorded (as appropriate)
- Confirming appointments 24 hours in advance
- Coordinating the appointment book with residents, faculty and patients
- Coordinating laboratory cases, patient appointments, and recalls
- Initiating calls to schedule recall and re-care appointments
- Responding to patients' and dentists' questions directly within scope of position
5
Skills For Senior Field Clinical Representative Resume
- Arranging for special needs when applicable
- Obtaining initial patient insurance and demographic information
- Correcting issues related to PA and exception requests
- Greeting patients and confirming appointments
- Performing basicmathematical calculations
- Setting up new patients in AXIUM
6
Skills For Clinical Field Representative Resume
- Obtaining authorization for clinical care and procedures
- Evening and weekend rotations
- Position requires standing, sitting for extended periods.Ability to lift or exert up to 25 pounds
- Assist with scheduling members medical appointments to ensure that the Health Plan customers receive routing or follow-up care as indicated
- Help expedite patient financial and medical record processing
- Self-motivated and self-directed, with ability to multi-task while remaining highly-organized and attentive to detail
7
Skills For Clinical Admissions Representative Resume
- Knowledge of health insurance and registration/scheduling
- Initiate assessments on members by obtaining all necessary member demographics and any available clinical information
- Provide assistance to other departments during periods of backlog
- Computer proficiency in database, word processing and spread sheet management required
- Provides accurate and complete responses to inquires regarding treatment eligibility and procedures
- This is a time-limited position
- Working closely with Medical Affairs, Specialty, PA Admin and other internal partners to ensure that utilization management criteria, decision trees and drug lists are loaded and functioning properly
- Communicates with prospective sites about all programs offered at the University; explains the University’s Clinical Education Department organization and why the site would want to accept our students
8
Skills For Representative, Senior Field Clinical Resume
- Works with ACCEs, AFWCs, the Department head to coordinate clinical educator training and development at the University’s contracted sites or offer courses through the Educational Support Plan
- Triage phone calls, take accurate messages, and page on-call physicians
- Understand policies, procedures, and regulations related to patients
- Work with health care professionals and affiliated staff
- Represent Faculty Practice to the public in a positive, courteous, and thoughtful manner
9
Skills For Customer / Clinical Service Representative Resume
- Plan, organize, and coordinate work activities with others
- Multitask and function in a team environment
- Answer all incoming calls from patients, physicians, and other health care providers (internal and external), pharmacies, medical supply companies, drug companies, etc. Route calls to fellows, physician extenders, or physicians when appropriate
- Respond to patient and physician questions directly within scope of position
- Provide direct, real-time phone triage, patient services, and problem-resolution including registration, scheduling, prescription refills, laboratory/imaging results, and phone triage with an emphasis on timely, seamless, patient-centered service within the context of the clinic-specific protocols and scripting
10
Skills For Representative, Clinical Payments Resume
- Communicate directly with the providers and others throughout the UF & Shands system regarding patient needs as required. Communicate directly with medical doctors, physician extenders, and nurses to assist patients and coordinate care
- Responsible for checking overnight messages and faxes
- Gather and verify patient information including demographics, insurance coverage, and financial status. Obtain authorization for clinical care, procedures, and ancillary studies. Enter all scheduling information into Epic
- Respond to medical records requests from physicians and respond to outside requests for records from other physicians’ offices or hospitals. Print records, print orders, burn compact discs (CD), send facsimile messages, pack items to mail or ship, and scan documents
- Knowledge of the Epic program and the scheduling of medical patients
- Back up all positions of the Business Office (as necessary)
- Strong technical aptitude; the ability to understand, communicate and train others in use of complex medical software algorithms as it pertains to device therapy and diverse disease states
- Medical device sales, clinical education and/or clinical research experience
List of Typical Responsibilities For a Clinical Representative Resume
1
Responsibilities For Clinical Service Representative Resume
- Bi-lingual (English/Spanish) skills
- Knowledge of Axium
- Point of Service Operations – Responsible for client check in. Greets clients, schedules and/or confirms appointments. Determine client eligibility for services. Provides HIPAA information as necessary. Directs clients to complete paperwork or pay fees if appropriate. Assists clients with questions or concerns. Acts as witness for documentation needing signatures
- Coordinates patient’s access to clinical services. Schedules patient appointments and obtains prior medical records, authorizations and prior lab results as necessary. Arranges for special needs when applicable. Obtains initial patient insurance demographic information. Uses the electronic medical records system, EPIC to post communication messages to the counselors and physicians
- Schedule appointments and tests including referral scheduling and pre and post-clinic visitations. Under faculty and team leader direction, schedule special patients, such as physician-directed clinic bumps. Work with other sub-specialties to arrange required ancillary tests, obtains authorizations (when necessary), and provide updated reports to clinical staff
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