Medical Administrator Resume Sample
Tavares Schowalter
69796 Harris Light,
Dallas,
TX
+1 (555) 592 7801
Work Experience
Medical Administrator
02/2016
-
PRESENT
Boston, MA
- Exam and re engineer operations and procedures
- Performing Medicaid program analytical support and problem resolution to assure program standards are appropriately operating within the claims processing and payment systems
- Providing Medicaid senior business systems analyst services to assure timely and accurate implementations of Federal and State mandates, executive branch initiatives, and regulatory program actions
- Conducting design analysis, oversight and testing of Medical Assistance information processing system development and maintenance activities
- Oversight of contractor activities involving system impacts
- Monitoring health payer industry standards and laws to identify impacts to Alaska Medicaid
- Ongoing assessment and assurance of MMIS compliance with health care payer industry standards
Medical Assistance Administrator
11/2009
-
01/2016
Los Angeles, CA
- Oversee facility’s membership and implements center activities to retain members and ensure their satisfaction with the center and plan. Responsible for reducing the centers’ retainable Medicare dis-enrollments
- Conducts routine meetings with the staff (including PCP’s) and documents topics discussed, action plans and staff feedback
- Monitors aging of claims to ensure timely follow-up and payment
- Participates in administrative staff meetings and attends other meetings and seminars, as required. Assists in evaluation of reports, decisions, and departmental results in relation to established goals. Recommends new approaches, policies, and procedures to influence continuous improvements in department’s efficiency and services performed
- Read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to effectively present information and respond to questions from customers, employees of the organization and the general public
- Contact payers to check claim status and reimbursement
- Phone appeals on denied claims
- Contact payer regarding carrier issues
- Provide Call Center or Customer Service Coordinator backup as needed
Medical Centre Administrator
08/2003
-
10/2009
Los Angeles, CA
- Define problems, collect data, establish facts, and draw valid conclusions. Ability to write routine reports and correspondence
- Your level of expertise and number of years of using each of the Microsoft products listed above
- Your experience performing research, data analysis, and reporting
- Member eligibility requirements and member-related interfaces
- Member eligibility data load and error reports
- Member information table structures within the claims processing system
- Claims processing system usage of member-related information
- Claims processing member-related exceptions
- Travel to Chiswick – ideally one day per week
Education
Webber International University
1998 - 2003
Bachelor's Degree in Management
Professional Skills
- Strong work experience that demonstrates proficiency in using the MS Office program applications (Word, Access, Excel, Outlook)
- Strong administrative, communication, and computer skills
- Excellent IT skills including MS Office
- Advance MS Word skills
- A leadership style that is member centered, and builds on skills and talents of the team
- Experience achieving results working in a lean/continuous improvement environment
- Experience growing and developing leaders
How to write Medical Administrator Resume
Medical Administrator role is responsible for design, technical, health, testing, reporting, conducting, analytical, leadership, compliance, credit.
To write great resume for medical administrator job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Medical Administrator Resume
The section contact information is important in your medical administrator 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 Medical Administrator Resume
The section work experience is an essential part of your medical administrator 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 medical administrator responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular medical administrator position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Medical Administrator resume experience can include:
- Excellent technical writing skills with demonstrated ability to effectively communicate highly technical concepts to non-technical business associates
- Verifiable effective communication skills presenting complex ideas or data; both verbally and in writing; in a clear, logical, precise and professional manner
- Job history confirming excellent interpersonal, organizational, analytical, detail-oriented and teamwork-oriented skills
- Professional work experience applying health payer industry standards, including electronic and paper claims requirements, code sets, and valid value sets
- Demonstrates effective communicating vision, organizational strategy, goals and setting clear direction
- Verifiable subject matter experience in Alaska Medicaid provider billing and payment standards or comparable experience
Education on a Medical Administrator Resume
Make sure to make education a priority on your medical administrator resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your medical administrator 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 Medical Administrator Resume
When listing skills on your medical administrator 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 medical administrator skills:
- Experience demonstrating your skills and abilities to work effectively in both a team setting and on an independent basis
- Strong communication skills with ability to make oral presentations and to communicate effectively on an individual level
- Work experience demonstrating your excellent interpersonal skills and your ability to handle stressful situations with tact and diplomacy
- Skilled in technical writing with demonstrated ability to effectively communicate highly technical concepts to non-technical business associates
- Work experience accurately and effectively communicating with peers, superiors, and the public in both written and oral formats
- Evidence of effectively communicating vision, organizational strategy, goals and setting clear direction
List of Typical Experience For a Medical Administrator Resume
1
Experience For Medical Assistance Administrator Resume
- Expert skills in health payer industry standards including HIPAA standards for privacy, security, transaction and code sets
- Highly skilled in the use of software applications including MS Word, Excel, and Access and decision support systems
- Effective contract oversight and management
- Evidence of learning from experimentation/mistakes and proactively seeking feedback and working on self-development
- Filing and retrieving information and documents, data entry, typing letters and looking after visitors
- Assisting with interviewing and hiring
- Liaising with applicants, answering queries and assisting candidates through the medical aspects of the application process where required
- Representing the division in fair hearing cases
2
Experience For Medical Center Administrator Resume
- Escalating issues or seeking guidance on specific cases from Team Leaders or medical contacts (Medical Experts, Chief Medical Officer etc)
- Organising and storing paperwork, documents and computer-based information
- Answering the phone and responding to queries (from both internal and external customers)
- Assisting with reports and day to day operations
- Working within reports
- Review clinical, getting reference from hospitals and verifying insurances, verifying how long a patient stay
- Coordinate and conduct design analysis, systems analysis and testing of changes to the Alaska Medicaid pharmacy claims processing system
3
Experience For Medical Centre Administrator Resume
- Your level of expertise and number of years using each of the Microsoft products listed above
- Claims processing outcomes, with an emphasis as first-level SME on professional claims
- Health payer industry standards impacting Alaska Medicaid
- Conduct testing, analysis, and oversight of MMIS maintenance and development efforts, as well as contractor activities with system impacts
- Expert knowledge in Alaska Medicaid provider billing and payment standards
4
Experience For Assistant Medical Group Administrator Resume
- Analyze expenditure and utilization data for program development, program maintenance, and program monitoring
- 65wpm + typing score
- Cover Letter,addressing the KSAEs stated above
- Analyze expenditure and utilization data for program development, program maintenance, program monitoring to support preparation of program budget
- Subject matter expertise in Alaska Medicaid MMIS claims processing standards
- Conduct first/second level review of work performed by contractor(s).Communicate across Division staff and contractors on specific project rules and timelines
- Knowledge of state and federal Medicaid environment and trends; health care delivery systems, policies, and procedures
5
Experience For Medical Group Administrator Resume
- Research, analyze, and interpret regulations, policies, and procedures
- Assist with design and implement healthcare program initiatives and projects
- Extract, analyze, interpret, and report data
- Excellent oral and written communication skills; ability to convey complex policy and technical information in an accurate, concise, and logical format to a wide array of stakeholders
- Establish and maintain effective collaborative relationships with a wide array of stakeholders
- Work productively both as part of a group and individually
- Excellent time management skills, ability to manage stressful and time-sensitive situations, flexibility when managing competing priorities,and the ability to prioritize responsibilities to ensure that all deadlines are met
- Previous work experience in medical case management
- Knowledge of the Health Insurance Portability and Accountability Act (HIPPA) as it relates to the responsibilities of the position
6
Experience For Medical Center Administrator Pipc-greer Resume
- Assisting providers with questions regarding Medicaid coverage of home infusion therapy, hearing services, respiratory therapy services, private duty nursing services
- Developing, maintaining, and communicating regulations, provider manuals, outreach materials, and educational modules by serving as subject matter expert in areas of programmatic responsibility
- Ensure all related reports, labs and information is filed is available in patients’ medical records prior to their appointment
- Escort patients to exam rooms, interviews patients
- Give instructions to patients as instructed by physician or physician assistant
- Keep exam rooms stocked with adequate medical supplies, maintain instruments
7
Experience For Associate Medical Group Administrator Resume
- Take telephone messages and provide feedback and answers to patient/physician/pharmacy calls
- Triage and process messages from patients and front office staff to physicians and physician assistants
- Maintain all logs and required checks (i.e. refrigerator temperatures, emergency medications, expired medications)
- Medicaid Management Information System (MMIS) and Interfaces
- Federal requirements, legislative actions, and regulatory changes that affect Alaska Medicaid
- Serve as unit specialist on MMIS Provider functional area and provide technical assistance on provider issues by researching provider billing issues to identify problem source and solutions
- Serve as first-level Subject Matter Expert on professional claims and MMIS Interfaces
- Verifiable skills working with decision support systems or relational databases that include the design of moderately complex technical queries to extract specified data and the use of analytical tools to evaluate and compile information and deduce logical conclusions
- Coordination and implementation of Medicaid Reform within the MMIS
8
Experience For Marketing & Medical Affairs Administrator Resume
- Coordination of work flow between various Medicaid Reform stakeholders
- Evaluation of Medicaid Reform projects and program policies for their impact on systems and Division operations
- Coordination of Medicaid Reform systems policies and projects across all Divisions with the Department of Health and Social Services
- Design, development and implementation of methods and standards for validating management and administrative reports, recurring federal reports, and recurring audit data extracts that relate to the Medicaid Reform Initiative
- Contractor oversight involving system impacts
9
Experience For Medical Center Administrator Pipc-san Antonio Resume
- Demonstrated experience leading a team in conducting business rule and design analysis, and quality assurance review of modifications for a claims processing system
- Knowledge, skills, abilities and experience working both independently and interdependently to analyze design concepts and system modifications for thoroughness, accuracy and compliance with federal and state standards for Medicaid
- Expert knowledge in Alaska Medicaid MMIS claims processing standards
- Successful, positive collaboration with multi-functional areas to assess business needs and communicate technical design concepts
- Detailed, comprehensive and technically-oriented skills in conducting review of system testing documents, audit trails, system output and related reports and documents
10
Experience For Medical Oncology Practice Administrator Resume
- Work history verifiable by references that demonstrates the ability to take initiative and find new approaches to improve work processes with limited supervision
- Manage established processes, policies, rules and data for multi-division or multi-service projects/programs, QA projects, and QA initiatives
- Make recommendations for regulations, policy, program descriptions, program processes, and position papers
- Conduct research and data analysis to maintain measure and monitor multi-division or multi-service projects/programs
- Direct support of the office manager
- Work independently under general direction from supervisors and/or other staff
- Provide accurate data entry with attention to detail
- A complete chronological job history/resume showing all previous employment and any breaks in employment. Include employer and supervisor contacts (names, addresses, and phone numbers), dates of employment, job title, and brief job description
List of Typical Skills For a Medical Administrator Resume
1
Skills For Medical Assistance Administrator Resume
- Exemplary internal and external customer service skills, including collaborative efforts, outreach, education, and problem resolution, and
- A strong and balanced combination of strategic/consulting and day-to-day clinical operations experience
- Ensuring deliverables are compliant with federal and state regulations and department priorities; facilitating work efforts and work groups
- Experience working with developing partnerships with providers, policy making bodies, and/or family support agencies
- Experienced interested and engaged in capital management, space planning and building
- An accomplished strategic leader; experience in setting strategy and implementing plans to operationalize vision of the medical group and service area
2
Skills For Medical Center Administrator Resume
- Demonstrated success in collaborating and forming strategic partnerships with physicians
- Previous work experience in public speaking and/or making presentations
- Experience with Medical administration (high call volume, transferring calls to appropriate departments)
- Experience with medical documentation, claims, and billing practices
- Experience with medical documentation, claims, billing practices
- Previous work experience processing worker’s compensation claims
- Experience with PBX
3
Skills For Medical Centre Administrator Resume
- At least one – two (1-2) years of front office experience
- Experience managing in a complex union/ management environment
- Highly skilled in software applications including MS Word, Excel, Access, Outlook, Power Point, and decision support systems
- Strong working knowledge of Medicare Part D and coordination of benefits for Medicare to Medicaid claims
- Demonstrated leadership and success in ambulatory as well as hospital operations
- Demonstrates openness to feedback and continuous development of self
- Experience in the healthcare arena desirable
4
Skills For Assistant Medical Group Administrator Resume
- Experience in health care claims billing
- Excellent knowledge of the regulatory process and how to read, interpret and apply regulations to business practices
- Developing and implementing thorough and relevant data mining and evaluative measures
- Creating PO’s, work in/out of medical records system, and also tracking metrics
- Providing technical support and assistance with the research, planning, development, implementation, and management of reform efforts
- Monitoring and tracking reform efforts
- Researching and resolving provider claims and enrollment issues and appeals
- Developing and communicating utilization management policy
- Working knowledge of health care services and delivery systems
5
Skills For Medical Group Administrator Resume
- Serving as the Part D administrator
- Ensuring that information is conveyed timely and accurately to involved stakeholders
- Collaborating with division staff to facilitate timely and accurate modifications to program regulations and the Medicaid State Plan
- Serving as reform liaison and subject matter expert to internal and external partners
- Providing weekly and ad hoc progress reports
6
Skills For Medical Center Administrator Pipc-greer Resume
- Working knowledge of health care delivery systems, policies, operations, and procedures at the State and federal levels
- Researching, identifying and applying national program standards
- Ensuring program compliance with all state and federal laws and regulations, and
- Provides information regarding medical usage to the Human Resources Division, relating to sworn members seeking promotion
- Ensures proper recording and reporting of Medical and Limited Duty cases for adherence to OSHA regulations
7
Skills For Associate Medical Group Administrator Resume
- Participates in personnel hiring and strategic planning
- A champion of change and innovation by pursuing and utilizing new strategies, tactics and technologies. (Tech savvy)
- Subject matter expertise in Alaska Medicaid MMIS claims processing standards and Alaska Medicaid provider billing and payment standards
- Research, data mining, statistical analysis, and reporting
- Serve as an expert on health payer industry standards and Medicaid pharmacy billing and processing standards
- Works with other city agencies and Department units on matters pertaining to medical administration services
- Represents the Police Department and testifies at hearings pertaining to disability pensions,
8
Skills For Marketing & Medical Affairs Administrator Resume
- Medical claims coding and resolution
- Contract management, including quality assurance and improvement, and education
- Coordinate and conduct design analysis, systems analysis and testing of changes to the claims payment and financial areas of the MMIS
- Proven interpersonal skills with the ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives, medical groups, IPA’s, community organizations and other health plan staff
- Manages medical case reviews and approves outside medical care and surgical procedure clearances for sworn members with On-Duty injuries Develops and implements medical quality assurance standards
- Monitors long-term disability cases and tracks Medical and Limited Duty status, leaves of absences and other expenses recommending changes and improvements
- Confers with the department’s Medical Deputy Director to address concerns regarding medical protocols, treatment, and other medical services provided to sworn members
- Works with outside medical providers ensuring that health care service provisions are in accordance with departmental standards by evaluating contracted clinical operations and procedures and recommending new policies in the area of healthcare administration
- Prior experience leading and managing in a complex union/management environment
9
Skills For Medical Center Administrator Pipc-san Antonio Resume
- Demonstrated ability to establish and maintain effective relationships with other stakeholder agencies and individuals dealing with complex issues
- Demonstrated success in building productive, trusting, respectful, collaborative working partnerships across TPMG and KP entities
- Experience in growing/developing teams and working through direct reports to achieve results
- Organize, prioritize, and plan workload to meet deadlines
- Background in LEAN/performance improvement and successful in applying PI tools and techniques to improve operations and the patient care experience
- Approves payment authorization for medical services rendered by outside providers
10
Skills For Medical Oncology Practice Administrator Resume
- Develops medical and psychological case management concepts ensuring case managers are accountable for their assigned caseloads and their assessments of Limited Duty status and Medical leaves of absence cases
- Complies with the Police Department’s General Orders and policies and procedures for Medical Services
- Testifies in court and at administrative proceedings as required
- Assesses travel requests for feasibility and approves travel for sworn members on Medical roll
- Research, analyze and interpret regulations, policies, and procedures
- Excellent oral and written communications skills; ability to convey policy and technical information in an accurate, concise, and logical format to a wide array of stakeholders
- Self-starter, successful in leading new projects and programs from idea/concept to implementation
List of Typical Responsibilities For a Medical Administrator Resume
1
Responsibilities For Medical Assistance Administrator Resume
- One (1) complete chronological job history/resume showing all previous employment and any breaks in employment including employer and supervisor contacts (names, addresses, and telephone numbers), dates of employment, your title, and a brief job description
- A complete chronological job history/resume showing all previous employment and any breaks in employment including employer and supervisor contacts (names, addresses and telephone numbers), dates of employment, your title and a brief job description
- A complete chronological job history/resume showing skills, educational background, and all previous employment and any breaks in employment. Include employer and supervisor contacts (names, addresses, phone numbers, email), dates of employment, job title and brief job description
- Two (2) examples of technical writing skills
- Cover letter,addressing the KSAs stated above
2
Responsibilities For Medical Center Administrator Resume
- A complete chronological job history/resume showing skills, educational background, and all previous employment and any breaks in employment. Include employer and supervisor contacts (names, addresses, phone numbers, email), dates of employment, job title, and brief job description
- One (1) complete chronological job history/resume showing all previous employment and any breaks in employment including: employer and supervisor contacts (names, addresses, and telephone numbers), dates of employment, your title, and a brief job description
- A complete chronological job history/resume showing all previous employment and any breaks in employment including: employer and supervisor contacts (names, addresses, and telephone numbers), dates of employment, your title, and a brief job description
- Subject matter expertise in Alaska Medicaid provider billing and payment standards
- Accomplished strategic leader; able to create strategy and implementation plans to operationalize vision of the medical group and service area
- A champion of change and innovation by pursuing and utilizing new strategies, tactics, technologies, to improve Total Performance, employee engagement, and wellness
- A leadership style that is member-centered, and builds on the skills and talents of the team
3
Responsibilities For Medical Centre Administrator Resume
- A skillful communicator; able to craft communication and engagement strategy that inspires commitment and energizes the team to achieve Total Performance
- Makes clear and solid decisions on a timely basis, and drives for results through influence, engagement, and data, aligned with TPMG strategy, values, and culture
- Complete chronological job history/resume showing all previous employment and any breaks in employment including: employer and supervisor contacts (names, addresses, and telephone numbers), dates of employment, your title, and a brief job description
- Experience in achieving results working in a lean/continuous improvement environment
- Demonstrated experience in balancing strategic direction and operations - involving others (including labor) to gather information necessary to generate alternatives, make the best-informed decisions and ensure buy-in/build consensus
- Strategic; oganized and purposeful
4
Responsibilities For Assistant Medical Group Administrator Resume
- Two (2) of your most recent job performance evaluations, if available
- Three (3) letters of recommendation, and
- Master's required in health care, hospital, business or public administration, or related field
- One year leading/supervising on-site inspections and reviews of health care facilities and programs for compliance with licensing and certification requirements. This experience is equivalent to a Health Facility Surveyor II with the State of Alaska
- Design, develop and implement processes, policies, rules and data for multi-division or multi-service projects/programs, QA projects, and QA initiatives
5
Responsibilities For Medical Group Administrator Resume
- Recommends regulations, policy, program descriptions, program processes, and position papers
- Design research and data studies to maintain, measure, and monitor multi-division or multi-service projects/programs
- Proactive ‘can do’ attitude
- Detailed, comprehensive and technically-oriented analytical skills in conducting review of system testing documents, audit trails, system output reports and similar documents, analyzing review findings, identifying problems and developing and implementing appropriate corrective actions
- Excellent analytical skills in conducting reviews of system testing documents, system design documents, and reporting with demonstrated skills in analyzing findings, identifying problems, and developing and implementing solutions
- Highly skilled in software applications, including MS Word, Excel, Access, Outlook, PowerPoint, and/or decision support systems
6
Responsibilities For Medical Center Administrator Pipc-greer Resume
- Development, interpretation and application of regulations, manuals, and other health care policy and procedures
- Audit response and resolution
- Team and role agility
- Excellent organizational skills, ability to set and manage competing priorities and meet deadlines, attention to detail, and ability to work both independently and as part of a team
- Experience in Fair Hearing representation including writing position statements that include all pertinent state statutes and regulations as well as Federal Code of Federal Regulations, then presenting the Division's position before an Administrative Hearing Officer
- Understanding of Medicaid Program Integrity and Quality Assurance practices and the ability to conduct both utilization reviews as well as clinical quality assurance reviews for Behavioral Health records
7
Responsibilities For Associate Medical Group Administrator Resume
- Demonstrated ability to build strong productive relationships with partners and coworkers
- Communicate complex behavioral health program information to higher management and to external interests, both orally and in writing
- Verifiable proficiency working with a variety of data sets, data formats, relational databases and the interface tools required to access and query data
- Translate regulatory language to lay terms to assist both recipients of services as well as providers
- Familiarity with the Army is desirable, but not essential
8
Responsibilities For Marketing & Medical Affairs Administrator Resume
- Review and interpret processes, policies, rules and data for continuous quality improvement purposes, on special Quality Assurance Team projects and initiatives
- Medical Assistant/Administrative Assistant
- Answers phone, file, and greet patients
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