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Experienced Transplant Coordinator with 15+ years of experience and a significant background in progressive roles within the medical industry. Experienced in reviewing complex healthcare claims, overseeing the organ transplant process, and leading cross-functional teams. Equipped with a keen ability to manage large-scale projects, implement process improvements, and foster positive rapport with vendors, patients, co-workers, and members of executive management.
Medical Claim Management
Attention to Detail
Direct a variety of administrative and operational functions within a fast-paced environment with a focus on increasing productivity and efficiency
Act as a Team Lead for a team of RN Case Managers and Social Workers which requires providing individualized feedback and coaching in addition to overseeing employee related issues
Review complex cases on a regular basis in order to ensure members qualify for services, monitor recorded calls for service quality, and provide feedback to customers on plan related items
Provide assistance during emergency situations which required a significant ability to work effectively under pressure along with a knowledge of local emergency services
Facilitated the management of disability claims within the organization which required reviewing claim facts and determining claims settlements
Utilized superior time management abilities in order to prioritize cases based on urgency, reviewed claimant medical records, and ensured claim policies and procedures were followed
Built positive relationships with Physicians and team members and successfully fostered a positive working environment which improved employee morale levels
Coordinated day-to-day administrative operations which included analyzing both pre and post service claims in order to determine eligibility along reviewing plan benefits
Maintained a keen knowledge of clinical guidelines and federal regulations and worked closely with Medical Directors in order to resolve claim issues
Acted as a subject matter expert in several areas such as utilization management, complex claims, and large-scale claims
Directed all transplant logistics within a fast-paced environment with a concentration on providing high-levels of support to both living donors and recipients
Provided information and feedback to patients regarding the transplant process, maintain on-call status in order to respond to donor offers, and addressed patient concerns
Managed the care for pre and post-operative transplant patients and submitted regulatory paperwork to agencies such as UNOS, CMS, Joint Commission, and insurance companies
Successfully handled various administrative operations which included building relationships with transplant centers, specialty providers, and other healthcare providers in order to review both actual and proposed medical services and compare to coverage guidelines
Made appropriate recommendations to UMR plan members regarding plan services, completed comprehensive benefit reviews/assessments, and identified members for specific transplant management activities
Provided superior levels of medical support to patients diagnosed with cardiac, pulmonary, renal, surgical, and diabetic issues
Assessed patients for changes in medical status, monitored vital signs, implementing individualized treatment plans, and administered medication via IV
Coached/mentored new team members, assisted Physicians with central line insertions and chest tube placement, and acted as a PRN for the Mercy Blood Borne Pathogen Hotline
Hiring Agent Name
I am currently seeking a challenging career opportunity in a (INSERT TITLE OF TARGET POSITION) capacity and am submitting my resume for your review. In advance, thank you for your time and consideration.
As demonstrated in the accompanying resume, my professional qualifications include a strong background in administrative and nursing roles with a focus on managing transplant donation logistics, coaching patients/family members on transplant procedures, and fostering positive relationships with members of the medical community. In addition, I have a keen ability to supervise staff members and provide in-depth individualized coaching.
To complement my professional experience, I also possess stellar interpersonal and communication skills with an impressive ability to build positive relationships with co-workers, patients, and members of management.
As an employee, you will find me to be a driven team player committed to supporting you in achieving your objectives through superior performance. I am confident that I could be a valuable asset to your organization, and look forward to interviewing with you in the near future.
Yyyyyy x. yyyyyy
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