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Click here or scroll down to respond to this candidateCandidate's Name
She has 9 months of Data Abstraction experienceShe holds an active Certified Electronics Health Records Specialist certification (CEHRS)She has experience with medical record reviewShe has experience with Medical Billing and CodingShe is proficient in data entry and reviewShe is located in Media, PAMedical Office Manager (CPPM) Certified Electronics Health Records Specialist (CEHRS), Certified Medical Administrative Assistant (CMAA)Work ExperienceCardiology Access Scheduling CoordinatorChildren's Hospital of PhiladelphiaPhiladelphia, PAApril 2021 to PresentCoordinates the administrative duties relevant to cardiac surgical operations, including surgery scheduling. It may also include other administrative duties as needed.Coordinates complex appointment scheduling of various pediatric specialtiesLinking Pre visits consults, and ancillary services required for assigned specialty services within the department.Schedules patient appointments when needed, instructions related to surgery, ensuring OR block time is efficiently utilized.Coordinates combined surgical cases with other physician practices across the organization.Schedules surgical cases for specialized diagnosis.Schedules physicians for surgery at outside facilities.Coordinates all aspects of scheduling, including procedure.Manages department and Qgenda provider surgical case calendars.Interviews patients and families to obtain complete and accurate demographic and financial information.Ensures that all necessary questionnaires and forms are completed at the time of scheduling, prior to patient surgical procedure.Enters data into system for registration, billing, patient tracking, and charge capture. Completes case order requests, additional equipment (e.g., laser, implants, etc.).Handles all surgery scheduling calls.Coordinates surgeries with radiology.Obtains medical clearance for surgery (e.g., dental, cardiac, Ortho, ENT).Obtains surgical consents (DFACS or outside agencies with legal guardianships)Provides accurate, detailed information to patients regarding test preparations, time of patients' scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.ECHO, MRI, Patency Ultrasound CT Surgery - coordinate surgery for adults and schedule post-op visits for adult patients.Patient Service Representative full time/Urgent Care PRNChildren's Hospital of Philadelphia -Philadelphia, PAJuly 2015 to PresentSupport physicians and nurses in maintaining a Patient/Customer Service focus.Welcome new patients to specialty care center and aids what medical specialty care department they need to visit.Direct Medical Assistant/Clinical Personnel to Specialty Care patients arrivalMaintained day to day batching report of Physician Billing and Hospital BillingProvided support for Urgent Care DepartmentPoint of Contact when 911/Emergency scenarios require redirection of staff and patients.Collect scripts, and enters accurate/changed demographic and insurance informationCollect payments associated with services rendered and reconciliation of daily services.Assisting Patients and their families to rescheduling of appointments and obtaining appropriate insurance referrals and authorizations as needed per insurance guidelines.Adhering HIPPA guidelines.Knowledge of EPIC, and Microsoft office, Excel, QGENDAPatient Service Representative IIMain Line Health Riddle EDMedia, PAFebruary 2014 to April 2016Supported the physicians and nurses in maintaining a patient/customer focus.Greeted, instructed directed and scheduled patients and visitors, in the Emergency room, outpatient register for labs, radiology, mammograms, Dexa scans, CT scans, ultrasounds, MRIs, and x-rays.Collected scripts, and enters accurate/changed demographic and insurance information, collecting payments associated with services rendered and reconciliation of daily services.Facilitated efficient and timely services to patients and their families such as scheduling appointments, answering phones, and obtaining appropriate insurance referrals and authorizations as needed per insurance guidelines.Adhered to and following HIPPA guidelines.Knowledge of Galvan on, Microsoft word, Invision, smart chart, Excel, HDX, Rumba, and clinical.Worked as Patient Resource Representative at Newton Square, and Broomall Lawrence Park shopping center locationsAssistant ManagerMain Line Health -Media, PAJuly 2013 to April 2016Created positive relationships with customers and patients restock shelves as items are soldOpening and closing procedures accurately counting registerAssistant General ManagerWawa Inc -Media, PAJanuary 2007 to December 2011Supervised the day-to-day task assignment for and performance of 5-50 Customer Service Associates and one to five management associates.Ensured a pleasant shopping experience for all customers, respond to customer complaints or inquiries and solicit customer feedback and input.Managed all matters relating to associates and the store team. This includes recruiting, hiring, training, coaching, managing performance and administering progressive discipline.Ensured execution of established safety, security, quality, and store operations policies, procedures and practices.Analyzed results and trends to prepare action plans, leverage the store's strengths and address areas of opportunity.Planed and prepared work schedules and coordinate daily assignments and activities of associates.Ensured profitability. Execute strategy through planning.Beverage Supervisor/ Manager on DutyHarrah's Chester Casino and Racetrack -Chester, PAJune 2006 to January 2007Managing of personnel in three separate casino restaurants.Created an atmosphere of enjoyment for patrons and employees.Provided training of casino restaurant employees in customer service satisfaction.Excelled in Customer Service Satisfaction on-site surveysArbitrator of Employee disputes and problems on casino floor.Manager on Duty for entire casino Food and Beverage Department.Maintained a satisfactory rating for Employee Retention.Demonstrated excellent customer service skills and ability to market for (5) food and beverage outlet during high coin-in timesScheduled requirements for outletsTrained of all employees in departmental procedures along with Harrah's organization policy and procedures.Restaurant SupervisorHarrah's Chester Casino and RacetrackChester, PA2006 to 2008Personal responsibilities include creating an atmosphere of enjoyment for patrons and employees.Demonstrated of excellent customer service skills and ability to market the entire food and beverage outletMet all scheduling requirements for outletsTrained of all fundamental departmental and Harrah's organization policy and procedures.Created a positive relationship with Back of House operations to ensure foods and beverages meet customers' demands.Planned and Implemented "Buzz Entertainment" to increase employee morale and productivityClinical Quality AnalystUnited HealthcareRemote2021 to 2022Communicate/interact with clients and providers (telephone, email, other written correspondence.Update claims (logs, dates, processes, documentation) in Equine system following company standards within established time standardsexperience managing clinical data management Phase I-IV studies. Resourceful, innovative, and respected data manager who continuously evaluates effectiveness of existing practices and seeks opportunities to improve project activities, departmental efficiency, and overall quality of data operations. Effective communicator who anticipates potential roadblocks and proactively seeks appropriate solutions.manually review and transfer patient data medications and immunizations between IT systems, ensuring information is accurate to support clinicians and patient safety.to create and implement strategies, work plans, policies and procedures and documents to maintain compliance with state and federal regulatory requirements including the Centers for Medicare & Medicaid Services, state Medicaid and NCQA accreditation standardsAbility to use applied analytics to forecast and trend retrospective and prospective HEDIS dataimplement Quality Improvement HEDIS projects and initiativesabstracted QVSD system Primary Source Verification Audit-PSVHEDIS collections.CCD, HCA claims research, OGS, CDSM Lab, Lab Portal extraction, HCA, Registry(immunization), CBP(Controlling Blood pressure), CCS (Cervical screening), CDC(Comprehensive diabetes care), CIS(childhood Immunizations), COA(care of older adults), COL(colorectal cancer screening), IMA( Immunizations for adolescents), LSC(Lead Screening in children), PPC(Prenatal and postpartum care), TRC(Transition of care), WCC(weight assessment and counseling for nutrition and Physical activity for children and adolescents). CPT Level 1 and HCPCS Level II Modifiers. ICD-9, ICD-10, CPT, HCPCS info.collections are sent to NCQA (National Comm for Quality Assurance)Conduct and manage outcomes of various studies that may include analyzing, reviewing, forecasting, trending, and presenting information for quality planning and management needsProvide analytical support and expertise when compiling and reporting informationDevelop and present recommendations and alternatives for managementAssume responsibility for data integrity among various internal groups and/or between internal and external stakeholdersLead and/or mentor associatesReport and analyze member care quality for the development of plans and programs to support continuous quality improvement using HEDIS and other toolsinterpret data, find solutions to organizational issues, and help implement those solutions as neededassess the data and ensure that appropriate staff receive reports containing relevant information once they've checked to make sure it's accurate. They implement plans to reach specific targets, which could be related to things like the success of specific procedures or services.Perform internal, external (vendor or regulatory), and clinical investigator site audits for supporting Clinical Operations servicesPerform internal, external (vendor or regulatory), and clinical investigator site audits for supporting Clinical Operations servicesPerform QA/QC reviews where applicable per site audit or project planManage and be accountable for professional employees and/or supervisorsCoordinate and supervise daily/weekly/monthly activities of team membersSet priorities for the team to ensure task completion and performance goals are metCoordinate work activities with other supervisors, managers, departments, etc.Identify and resolve operational problems using defined processes, expertise and judgmentProvide coaching, feedback and annual performance reviews as well as formal corrective actionAbility to work in aggressive timelines with end-to-end coordination with multiple groups (Dev, QA, UAT, other teams)Experience working with ALM/Jira, SQL/DB queries, basic Linux commandsevaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS / Star technical specifications for medical records.EducationMedical Office Management Certification in Medical Physician Practice Office ManagementBloomsburg University of Pennsylvania -Bloomsburg, PADecember 2018 to December 2019Masters in early childhood educationColumbus University2007Bachelors in early childhood educationColumbus University2006Advanced Certificate in Early Childhood Ed Director CredentialDelaware County Community College -Media, PA2006Associates in Early Childhood EducationDelaware County Community College2003 |
