Insurance Medical Examination companies offer the most professional and convenient method of
satisfying insurance company requirements for medical examinations. Insurance Medical Examiners' staff
are experts a performing medical examinations and obtaining the necessary information to assist with
purchasing an insurance policy designed for your applicant's specific needs.

PARAMEDICAL EXAMINER
Conduct personal interviews with insurance applicants to obtain the applicant's medical
history, record the applicant's height, weight, blood pressure and pulse. Exams also include collecting a
blood sample, a urine specimen, oral fluid (saliva), and an electrocardiogram (EKG),
depending on insurance company requirements. This information collected allows the insurance
company to perform a comprehensive evaluation of the applicant's current health.

Managed Access, Inc. is a managed healthcare consulting firm specializing in Medical Management Services with over 100 cumulative years of managed health care experience, customer service, and chart abstractions for HEDIS (Health Plan and Employer Data Information Set), a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans. Also including standardized surveys of consumers\' experiences, evaluating plan performance in areas such as customer service, access to care and claims processing. HEDIS is sponsored, supported and maintained by the National Committee for Quality Assurance (NCQA).

HEDIS Chart Abstractor (Remote)
Chart reviewer and data abstraction collector contracted with United Health Group to provide on-site HEDIS chart reviews for the purpose to audit Evaluation and Management (E&M) services performed by assigned medical providers.
ï Performed all onsite review services with efficiency and quality at medical facilities and other designated locations
ï Responsible for database searches and chart reviews
ï Reviewed assigned CPT, HCSPCS and ICD-9 codes and patient charts to determine review eligibility
ï Copied relevant components of medical record to support onsite review services according to guidelines
ï Responsible for uploading review data and associated documentation to centralized server system through the Internet and associated web portal within time parameters
ï Electronically downloaded onsite review forms to assigned laptop and data collection tool (DCT).
ï Communicated with provider offices and coordinators regarding scheduled site visits
ï Traveled to medical facilities as scheduled to complete onsite review services and as assigned
ï Represented to the medical facility staff with professionalism and politeness and abided by all HIPAA and associated patient confidentiality requirements

Correctional Medical Services (CMS) is the nation's premier provider of healthcare services to prisons and jails contracted with city, state and federal prisons and jails throughout the United States to provide quality healthcare services to the incarcerated populations ranging from 15 inmates to over 5,000 inmates.

Health Services Administrator
Administrator responsible for fiscal operations, financial planning and administration of prison infirmary health care services, which included a staff of 35 clinicians, dentists, nurses, allied health technicians and administrative staff to provide quality care while maintaining an efficient, cost-effective health services.
ï Managed health services activities, including plans and operations, managed care, human resource management, logistics management, patient administration, budgetary and fiscal management, medical manpower, medical facility management, and medical recruiting
ï Analyzed information to plan program changes or make recommendations to department administration to meet programmatic goals
ï Collaborated with staff, colleagues, and division directors in developing and implementing new program initiatives
ï Ensured compliance with policies, procedures, and medical standards
ï Evaluated staffing patterns to ensure adequate staffing to meet program and department goals
ï Assesses training needs and promoted training opportunities
ï Collaborated with outside agencies and health care providers in delivering health services
ï Controlled, directed, and maintained the use of all supplies and equipment assigned to health services
ï Assisted in developing a new facility and authorized facility modification

Gould & Lamb is a medical-financial services company that specializes in the preparation of Medicare Set-Aside Arrangements for insurance carriers and self-insured entities, providing a combination of healthcare, insurance, legal and financial assistance in the area of Workers' Compensation. They present information and analysis to parties needing to settle claims, set reserves and evaluate complex medical cases. Gould & Lambís clients include 23 of the nationís top 25 Workers' Compensation carriers, self-insured corporations, third party administrators, defense and plaintiff attorneys and structured settlement brokers.

Medical Care Evaluator Writer (Remote)
Prepared narrative reports and medical summaries after reviewing records and documentation provided
by the clients to determine the future medical care needs of an injured party and to accurately forecast
future medical costs related to the injury. Required extensive clinical expertise, analytical skills, attention
to detail, organization, and critical thinking abilities.
ï Assisted in the preparation of Medicare Set-Aside Arrangements for insurance carriers and self-insured entities for workerís compensation claims
ï Prepared narrative reports and medical summaries after reviewing records and documentation provided by the clients to determine the future medical care needs of the injured party
ï Prepared medical financial spreadsheets that established future medical expenses for the injured claimantís lifetime
ï Determined applicable coverage, medical necessity and appropriateness of charges related to injury claim
ï Reviewed and researched medical and surgical reports obtained from providers for contestability and pre-existing health histories
ï Reviewed ICD-9-CM, CPT, E&M and HCPCS codes to ensure medical necessity and appropriateness of charges related to the injury claim and communicated necessary changes to management team

An outpatient acute care clinic specializing in urgent minor care services to approximately 55-60 patients
per day. It is a division of JEFFERSON REGIONAL MEDICAL CENTER, a 471 bed not-for-profit, private
regional hospital.

Patient Care and Clinical Operations Coordinator
Administrative coordinator responsible for support and coordination of daily operations by providing nursing staff, physicians and ancillary staff with the required resources to meet patient needs and the operational objectives of the organization.
ï Assigned ICD-9-CM, CPT, E&M and HCPCS codes to the outpatient clinic for Urgent Care and Family Practice services and procedures
ï Responsible for overall revenue cycle management processes
ï Responsible for coding 55-60 medical records per 8 hours with an accuracy of 90- 95%
ï Reviewed and revised Charge Description Master (CDM) and ensured compliance with requirements of Medicare, Medicaid, managed care contracts, and insurance companies
ï Ensured daily Charge and Order Entry systems were correctly linked to the CDM in charging of services and requested CDM maintenance requests as needed
ï Performed daily audits of physician medical records and charges to ensure compliance with coding standards
ï Developed, implemented and coordinated quality assurance programs of clinical practices with current local, state and federal regulations, and compliance with laws and standards established by accrediting organizations
ï Developed an effective auditing and compliance program that included standards of conduct with respect to ethical billing practices and addressed specific areas of potential fraud
ï Conducted periodic meetings with healthcare team and providers that included chart and coding reviews for over/under coding patterns, coding patterns, revenue enhancement opportunities, billing and insurance department workflow including re-bills and payments
ï Educated physicians and clinical staff to appropriate documentation as required by medical
ï review
ï Responsible for research, proposal, design, implementation, and monitoring of the ECLIPSE electronic medical record practice management system
ï Recruited, screened, hired, oriented, trained and evaluated staff
ï Served as a liaison between the clinic and the Central Business Office

Bachelor of Science in Healthcare Management

Associate in Applied Science of Registered Nursing

Associate of Arts in General Education

Diploma in Practical Nursing