Sandra McLean

About Sandra McLean

Dedicated and highly persuasive skilled Negotiator and complex problem solver. Desire to bring skills to a new position with room for advancement. Eager to begin a challenging opportunity within a growing organization that will assist in building new skills while making a significant contribution to the success of the company. Facilitates positive and productive interactions between workers, leaders, and union representatives. Successful background reaching consensus and smoothing relations to maximize success of negotiations. Articulate and decisiveExperienced Medical Coder/Biller with a demonstrated history of working in the hospital & health care industry. Skilled in negotiating Single Case Agreements, Medical Case Management, Coding, Theory, Billing Process, Billing Solutions, and Microsoft Word and Excel, Strong healthcare services professional. I’m a 3 time Valedictorian graduate with high honors in English and Allied Heathcare with Administration.I am an analytical individual skilled at training and motivating employees, excelling at tasks in order to achieve established goals and client satisfaction. I consider myself to be an effective communicator continually focused on building and maintaining relationships on all levels, reaching my goals, and building my skillset.I go above and beyond my job description to ensure client satisfaction. SUMMARY OF MY QUALIFICATIONS Organized self motivator office professional, with over 27 years experience in both healthcare and insurance industries. Demonstrated proficiency with ICD9 & 10 coding and billing. Honed customer service, communication, and time-management skills acquired from interaction with a variety of insurance companies, peers, subordinates, and senior management. Practiced problem solver in regards to claims discrepancies, client challenges and estate billing. Exemplary leadership and management skills.

Experience

1. Provider Outreach Oc Escalations

   Optum

   Feb 2025 — Present · US

   Provider Relationship Management: Building and maintaining strong relationships with healthcare providers.Provider Education and Support: Providing information and education to providers on their obligations and rights, and assisting with network participation processes.Provider Contracting: Supporting provider contracting processes.Provider Outreach and Engagement: Engaging with healthcare providers to promote participation in initiatives aimed at improving access to medical records.Cross-Functional Collaboration: Collaborating with cross-functional teams to streamline processes, such as obtaining records.Data Collection and Reporting: Collecting data, reporting on findings, and maintaining accurate records for provider outreach projects.Process Improvement: Streamlining processes, such as obtaining records for lower-income areas.Communication Skills: Effective communication, both verbal and written.Problem-Solving: Addressing and resolving provider concerns and issues.Relationship Building: Building and maintaining productive and collaborative relationships with network providers and their administrative staff.Managed Care (Optional, based on company focus): Familiarity with managed care policies and networks. Increased provider engagement by 25%, significantly enhancing the efficiency of insurance provision in underserved communities.Streamlined the process of obtaining medical records for lower-income areas through collaboration with cross-functional teams, contributing to improved healthcare access.Established and nurtured relationships with a large network of healthcare providers, resolving their concerns and providing timely information and support.Participated in provider outreach initiatives, collecting data, reporting on progress, and maintaining accurate records to track provider engagement.

Education

• The Cittone Institute

  Business, Business/Office Automation/Technology/Data Entry

  1988 — 1991

• Penn Foster Group

  Health Services/Allied Health/Health Sciences, General

  2016 — 2018

• Advantage Career Institute Medical & Dental

  Medical Coding and Billing

  2009 — 2010

• International Open Academy

  Relationship coach

  2020 — 2020

• IAP Career College

  Relationship Coach

  2020 — 2020