Medical Information Specialist Resume Samples

Description :

1. Handled written and telephonic inquires to and from Primary Care Physicians, internal and external customers for all lines of business: Health Maintenance Organization (HMO), Blue Choice, and Self Referral Option (SRO).
2. Investigated authorization requests for medical/surgical procedures.
3. Provided information and assistance to Medical Management, providers, hospitals, Primary Care Group's as well as members.
4. Collected and record data to assist team members and nurses with data research regarding benefit limitations, historical authorizations, and paid claims data.
5. Resolved and identified claim issues cohesively with the claims department as well as external customers.
6. Provided training to all new employees who became a member of the clinical programs department.
7. Consistently exceeded monthly production goals with an accuracy rate of 98%, as a result, improved inventory within turn-around times within the department.

Experience

7-10 Years

Level

Management

Education

Associates Of Applied Science

Description :

1. Created, updated, and/or reviewed Medical Information content (e.g., Medical Information letters and FAQs) and custom (escalated) responses to inquiries in collaboration with the in-house subject matter.
2. Ensured complex scientific content is summarized in a concise, simple, and balanced.
3. Responded to unsolicited consumer, health care professional, and other external customer requests for clinical and scientific information received via the Call Center phone number, website/e-mail, and at scientific.
4. Provided information responses aligned with law, rules, regulations, internal policies, codes (e.g., Client Code of Conduct, ) and practices.
5. Assisted in the development, optimization, and management of in-house medical information.
6. Assisted with launch readiness plans for the Call Center that meet the scientific needs of customers through strong collaboration with internal.
7. Provided monthly reporting metrics for Medical.

Experience

5-7 Years

Level

Junior

Education

Diploma

Description :

1. Responded to unsolicited and solicited medical information questions through verbal or written channels from healthcare providers and patients by using the appropriate and researched scientific data available.
2. Responsible for identifying and recording adverse events and product complaints as well as processing fulfillment.
3. Crtiically and scientifically evaluated the medical information available to share it with HCPs.
4. Utilized FDA, regulatory and medical knowledge for documentation.
5. Provided medical and drug information input for updating the database for providing responses to HCPs.
6. Documented appropriately according to company and project guidelines and route the AE report to safety department o Documents AER and product complaint report based on the time line guidelines set forth by FDA and client.
7. Identified and handled suspected and or unexpected serious adverse reports o Member of social committee for boosting morale of the employees and managing other social activities.

Experience

5-7 Years

Level

Executive

Education

Bachelor's In Pharmacy

Description :

1. Created and reviewed new global and US standard response documents for five products in therapeutic area of Multiple Sclerosis.
2. Completed periodic reviews/updates for products in therapeutic area of Multiple Sclerosis.
3. Demonstrated ongoing scientific expertise relevant to therapeutic area, including products, disease state management, and emerging therapies (i.e. product certifications).
4. Integrated scientific expertise with knowledge of regulatory and compliance guidelines to ensure comprehensive review and development of standard responses submitted into the approval process.
5. Participated in updating Medical Information Style Guide for standard response documents.
6. Created and reviewed medical/scientific content for hot topics, sensitive issues Liaison between content team and contact center for trending hot topics.
7. Assessed and investigated requests for medical service authorization.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Personalized handling of inbound calls from consumers and healthcare professionals.
2. Maintained and updated (annually) SRL database for department.
3. Assisted in reporting of Adverse Drug Reaction and Quality Complaint reports as needed.
4. Overviewed the general working with Pharmacovigilance department and manager.
5. Kept renewed for the professional knowledge in the field of medical info, safety, and applicable areas of medical science to provide valuable services to the clients and company.
6. Documented and responded to internal and external medical information requests received via phone/email/fax/mail.
7. Responsible for receiving and handling after hours calls.

Experience

2-5 Years

Level

Executive

Education

High School Diploma

Description :

1. Assessed and investigated requests for medical service authorization and authorization.
2. Assisted nurse team members with data research regarding benefit limitations, historical authorizations, and paid claims data.
3. Familiared with ICD-9, CPT, and HCPCS codes.
4. Assisted provider with identification of appropriate codes for authorization.
5. Facilitated communication with providers regarding the status of requests for clinical review.
6. Assisted with on-the-job training of new employees.
7. Worked on special projects as assigned by a leader independently Educate and direct providers on medical management policy, procedures, and plan benefits.

Experience

5-7 Years

Level

Executive

Education

Master Of Science

Description :

1. Demonstrated the ability to fill in at a moment's notice, quickly mastering new systems, processes, and workflows.
2. Collected, recorded, and processed appropriate data into our Medecision database to offer providers authorization of approved services for Blue Care Network members.
3. Assisted nurse managers with data research regarding benefit limitations, facilitate communication with providers, identify relevant issues and resolve inquires, and educate and direct providers on medical management policy, procedures, and plan benefits.
4. Led team to reach goal for speed and accuracy, created a supportive team environment, was asked by a supervisor to train new hires when I only had two weeks on the job.
5. Used Diplomacy, critical thinking skills, time management, organizational and problem-solving skills.
6. Provided information and assistance regarding the Medical Management program to providers, hospitals, Primary Care groups, and members.

Experience

0-2 Years

Level

Entry Level

Education

Diploma

Description :

1. Provided high-quality, balanced, and timely clinical, medical and scientific information upon the request of external healthcare professionals as well as internal Baxter functional areas such as clinical development, marketing, sales, manufacturing, quality assurance, regulatory affairs, R&D, and legal.
2. Evaluated medical inquiries and utilizing appropriate sources (prescribing Information, literature searches) respond verbally or in writing to the customer.
3. Assisted in creating, maintaining, and updating a database of standard response letters, frequently asked questions, and other correspondence that can be utilized to respond to the request of internal and external customers.
4. Maintained working and current knowledge of published medical literature, disease states, and their treatments related to relevant Baxter products.
5. Continuously established a basic understanding and maintaining current knowledge of regulatory and quality requirements related to product support.
6. Assisted company regulatory and quality groups by providing input into the evaluation of product complaints and adverse events.
7. Provided support for medical information booths at conferences.

Experience

5-7 Years

Level

Executive

Education

GED

Description :

1. Retrieved patient charts.
2. Analyzed patient charts.
3. Scheduled appointments.
4. Answered telephone.
5. Organized new medical record department.
6. Created new forms for the chart.
7. Tracked RN and HHA visits to patient homes.

Experience

2-5 Years

Level

Executive

Education

GED

Description :

1. Helped to file and to keep patient charts up to date.
2. Answered phones, scheduled appointments, and entered data into a computer system.
3. Retrieved information from patient charts; faxed patient orders and lab results to other clinics.
4. Daily prepared patient charts for use on appointment and performed general clerical duties.
5. Enlisted to temporary position to apply clinical trial and literature evaluation experience.
6. Demonstrated skills in Drug Information, emerging changes in drug policy, and barriers to accessing NTD treatments, INDs, Orphans Drugs, and challenges in managing chronic diseases including NTDs, acute infections.
7. Provided expert technical information to Health Care Providers (HCPs) in treating NTDs and INDs according to Standard Letter Protocol (STPs) of drug manufacturers.

Experience

2-5 Years

Level

Executive

Education

Bachelor of Multidisciplinary