Andrea Moore

Clinical Admin Coordinator with over 20 years of experience in administration and patient care; adept in plan analysis, providing operational support, and resolving complex clinical admin issues. Expertise in clinical administration, strategic planning, and policy interpretation within Optum-United Health Group. Seeking to apply comprehensive knowledge and analytical skills to a new role.

Clinical Admin Coordinator Sr. (Field Based) at OPTUM -UNITEDHEALTH GROUP (2025-04 – Present)

Operates as an Optum ambassador (Clinical Admin) to support interdisciplinary care team with overall member coordination working with RNs or NP/PAs.

• Data entry and member chart management for: post hospital visits, quality, labs and meds.
• Creates, stores, maintains reports, documentation, database files, logs, and patient accounts.
• Obtain medical records following hospitalizations or physician appointments
• Scheduling member transportation or appointments
• Provide operational support, (backfill and care coordination) and manage shifting priorities.
• Salesforce/Pathway, PointClickCare, EMR, Outlook 365, Microsoft Office, reports time

Employer Services Specialist-Team Lead at GEORGIA DEPARTMENT OF COMMUNITY HEALTH - STATE HEALTH BENEFIT PLAN (2015-03 – 2025-01)

Provided comprehensive support for enrollment and eligibility issues in health coverage and analyzed benefits programs.

• Provide comprehensive support for enrollment and eligibility issues in health coverage
• Offer analytical assistance for benefits programs including research and administration (COBRA, ADA, FMLA, Flex Benefits).
• Address and resolve complex inquiries, complaints, and escalations regarding benefits.
• Gathers /compiles detailed or sensitive information from providers or applicants.
• Interpret and apply laws/rules, regulations, policies, and procedures for state employee and retiree health benefits (Medicare).
• Reconcile payroll discrepancies and contribute to system process improvements for data management. (ADP, Peoplesoft).
• Creates, stores, and maintains reports, documentation, scans, database files, logs, and patient accounts.

Healthcare Administrator at CAREMASTER MEDICAL SERVICES (2014-03 – 2015-02)

Assessed and implemented procedural modifications to enhance patient care and facilitated communication among stakeholders.

• Assessed and implemented procedural modifications to enhance patient care, ensuring adherence to quality standards
• Facilitated communication among management, clinical staff, and external stakeholders, contributing to comprehensive documentation and patient health monitoring. Medical records (EMR)

Pre-authorization Specialist at KOOL SMILES PEDIATRIC DENTISTRY (2005-06 – 2012-02)

Verified insurance benefits and obtained pre-authorization for dental services while maintaining HIPAA compliance.

• Verified insurance benefits (Medicaid) and obtained pre-authorization for dental exams and treatments, ensuring accurate and timely insurance payments.
• Prepared comprehensive patient care plans and maintained compliance with HIPAA regulations through meticulous management of disclosures and documentation using EMR-Dentrix software

Bachelor in Healthcare Management – Clayton State University

Associate Science in Health Science w/Concentration Information Administration – Georgia State University-Perimeter College (2015-05)

Certified Medical Assistant – Georgia Medical Institute (1999-05)