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@suasdeymcgovern
Patient-focused medical administrative professional with extensive experience.
With over 9 years of experience in the medical administrative field, I am a patient-focused professional skilled in insurance verification, pre-certification, and claims processing. My proven ability to reduce claim denials and ensure HIPAA compliance has significantly contributed to financial transparency in both hospital and outpatient settings.
Throughout my career, I have developed expertise in ICD-10, CPT coding, and EMR systems, along with a strong understanding of payer coordination, including Medicare, Medicaid, and commercial plans. My role as an Authorization/Verification Specialist at Intrepid USA allowed me to process authorizations and verify insurance coverage effectively, ensuring continuity of care for patients. I have consistently met and exceeded productivity goals, demonstrating my commitment to excellence in a high-volume healthcare environment.
In addition to my medical administrative experience, I have also worked in finance as an Incentive Compensation Specialist at Ryan LLC, where I managed bonus reporting and collaborated with payroll for audit reporting. My diverse background, including a managerial role in telecommunications, has equipped me with strong analytical and communication skills, making me a valuable asset in any healthcare setting.
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Work history, roles, and key accomplishments
Ryan LLC
Dec 2019 - Jan 2025 (5 years 1 month)
Managed bonus reporting, adjustments, and reconciliation for international and U.S. staff. Created ad-hoc compensation reports and maintained incentive data in firm systems.
Intrepid USA
Feb 2019 - Dec 2019 (10 months)
Processed authorizations and verified insurance coverage for various plans. Collaborated with payors and case managers to secure pre-authorizations for home health services, ensuring continuity of care.
Texas Health Center for Diagnostics & Surgery
Jun 2015 - Dec 2018 (3 years 6 months)
Verified patient eligibility, benefits, and authorization status prior to surgeries. Recovered thousands in denied claims weekly by managing authorization denials effectively.
Texas Health Resources (CBO)
Apr 2010 - Jan 2015 (4 years 9 months)
Reviewed imaging orders and secured authorizations by interpreting payer guidelines. Collaborated with physicians and office staff to obtain medical records and overturn denials.
Dallas Semiconductor / Maxim
Mar 2000 - Apr 2009 (9 years 1 month)
Managed bottlenecks and production issues to meet shipping plans and delivery targets. Supported engineering and manufacturing by generating ECNs, SWRs, and SARs.
Dallas Semiconductor
Dec 1995 - Mar 2000 (4 years 3 months)
Released work orders using accounting software and managed invoice processing. Worked with purchasing to coordinate material acquisition and inventory control.
Degrees, certifications, and relevant coursework
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