Medical Information Specialist Resume Samples

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Medical Information Specialists represent a healthcare facility in its relation with the media and the public and handle the following responsibilities: collaborating with medical directors, writing press releases, representing the organization in scientific fora, attending industry events, and completing other duties as assigned by directors. Typical job requirements seen on a Medical Information Specialist resume sample are knowledge of medical terminology, communication expertise, tact and diplomacy, being able to stay calm under pressure, decision making, and networking. Successful resumes in the field make display of a degree in mass communication or journalism.

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1

Medical Information Specialist

Delivered accurate and balanced information in response to complex inquiries related to on- and off- label therapeutic uses and safety guidelines. Compiled research and data from relevant medical literature creating detailed summaries for clinical replies.

  • Consolidated training materials and incorporated concise and relevant information reducing product training time by 50%.
  • Earned Top 1% in quality monitoring scores for customer service and case documentation.
  • Identified, investigated and accurately documented adverse events and product quality complaints maintaining compliance with federal guidelines and regulations and adhering to client specific policies.
  • Provided subject matter expertise in Respiratory and Oncology products.
  • Reviewed and evaluated team reports and responses ensuring accuracy, quality, and compliance.
  • Established and executed a process to handle complex inquiries from healthcare providers utilizing medical literature searches prior to response generation reducing unprocessed queries.
Candidate Info
44
years in
workforce
4
years
at this job
BA
Microbiology
MA
Administrative Science
PharmD
Pharmacy
2

Medical Information Specialist

Assess and investigate cases for medical/surgical authorization and authorize select services that do not require clinical review or judgment based on product knowledge

  • Assist providers and specialist with referral changes for approved, pending and retrospective authorizations
  • Data collection through inbound calls regarding referral intakes, questions and concerns, complete statistical data on cases for analysis of pre-service, retrospective or concurrent services.
  • Verify eligibility for members, provider networks as well as follow guidelines in regards to SharePoint, CareAdvance and Facets system
  • Collect and record appropriate data in order to issue authorization and route request for services that require medical review to appropriate nurse case manager
  • Assist nurse team members with data research and requesting documentation as necessary particularly regarding benefit/plan limitations and historical authorizations, educate and direct providers on medical management policy, procedures, plan benefits and co-pays for all products such as Medicare Advantage, and Commercial
Candidate Info
6
years in
workforce
3
years
at this job
AAS
Medical Practice-clinical Management
BA
Bachelor of Arts
3

Medical Information Specialist

  • Provide thorough analysis and investigation of authorization request for specialized medical/surgical/outpatient procedures in an expeditious and accurate manner
  • Provide information and assistance pertaining to the Medical Management program to providers, hospitals, Provider Care Groups(PCG), and members.
  • Identify relevant issues and route to appropriate department for action and resolution
  • Perform departmental functions such as: data preparation/presentation, interaction with internal and external sources to resolve inquiries.
  • Assist with on-the-job training of new employees as requested
  • Educate and direct providers on medical management policy, procedures, plan benefits and copayments for all products.
  • Promote and engage in positive and constructive daily team interactions
Candidate Info
13
years in
workforce
2
years
at this job
C
Medical Insurance Billing And Coding
BA
Business Management
4

Medical Information Specialist/ Utilization Management

Provide through analysis and investigation of authorization request

  • Assess and investigate requests for medical service authorization and authorize select services that do not require clinical judgment. [company name]of Michigan​
  • Collect and record appropriate data in order to issue authorization and route request for services that require medical review to appropriate team member(s).
  • Facilitate communication with providers regarding status on authorization and referrals.
Candidate Info
10
years in
workforce
2
years
at this job
C
Medical Assisting / Hemodialysis

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