Post Job Free

Resume

Sign in

Customer Service Medical

Location:
Loganville, GA, 30052
Posted:
November 14, 2013

Contact this candidate

Resume:

Dwayne C, BS, RHIT

Health Information Pro looking for a new opportunity

acazfu@r.postjobfree.com

Summary

Credentialed RHIT professional with strong information technology aptitude as well as proven ability to readily

master new technology. Dedicated to maintaining strict patient confidentiality. Expertise includes managing

medical accounts, analyzing medical records, and creating reports. Well-developed leadership skills and

decision-making abilities paired with excellent communication and interpersonal skills to communicate with

physicians, nurse practitioners, attorneys, vendors, etc. Handled all data with the highest level of confidentiality

and discretion. Computer literate in Microsoft Office suite. Working knowledge of HEDIS, ICD-9 and CPT-4

coding, Anatomy & Physiology, Microsoft Office Suite, Meditech 6.0, 3M Encoder Software, and various

office equipment.

GOALS: FileNet P8, and Healthcare Data Analyst Certification.

Experience

Release of Information Specialist at HealthPort LLC

May 2013 - September 2013 (5 months)

Responsible for abstracting clinical data for Kaiser Permenente release of information (ROI); specifically

medical record requests in a timely and efficient manner ensuring accuracy and providing customers with the

highest quality product and customer service. Adhere to company's compliance policy and HIPAA

regulations in all ROI.

Patient Access Specialist, PRN at Grady Health System

March 2013 - September 2013 (7 months)

Use Epic Cadence, ADT and Stork to access patient records in Emergency Critical Care unit, Admissions and

Labor and Delivery

Coordinates the collection of all estimated patient liabilities, including co-payments and unmet deductibles.

Verifies insurance benefits and coverage for inpatients and outpatients.

Responds to customer requests and answers questions regarding various service and account information.

Abide by all HIPAA and associated patient confidentiality requirements.

Medical File Reviewer (HEDIS) at Outcomes Health Information Solutions

January 2013 - May 2013 (5 months)

Accurately and efficiently conduct medical record review services for HEDIS.

Work in Meditech, Cerner, McKesson, and Epic to access patients records.

Scan relevant components of the medical record to support reviews performed.

Communicate effectively and professionally with care provider offices, clinics, hospitals, other clinical

facilities.

Travel to medical facilities in specified area of region from home to complete review services.

Page1

Abide by all HIPAA and associated patient confidentiality requirements.

President of HIT Student Guild at DeVry University

August 2012 - March 2013 (8 months)

Bring health information students and graduates together to establish and build relationships within the health

information industry.

Create committees and appoint chairpersons to assist conducting guild activities.

Lead Fitness Instructor at Put Up Your Dukes Foundation

March 2012 - January 2013 (11 months)

The Foundation’s purpose is to eradicate the disease of excess weight (Co morbidities: Type 2 Diabetes, High

Blood Pressure, High Cholesterol, Breast and Prostate Cancer…

I am a service provider for The City of Atlanta, Atlanta Public Schools, DeKalb County Schools, and

Coca-Cola.I worked with kids from age 6 to 18 in summer camps and after school programs, as well as adults

and seniors in churches and senior citizen community centers across Metro Atlanta by intergrating line

dancing and fitness.

Summer Intern/Technical Healthcare Writer at The Friedman Marketing Group

June 2012 - October 2012 (5 months)

Healthcare Technical writer on various topics ICD-10, ChargeMaster, Audit Management, EHR's, Healthcare

reform, esMD, and Audit Risks

ICD 10 Auditor at The Coding Source

May 2011 - February 2012 (10 months)

Skilled in abstracting data to ensure needed medical information has assigned codes to describe each

documented analysis.

Review documentation and accurately translate medical information into the appropriate code

Escalate issue(s) to lead/management as appropriately needed

Knowledge of coding convention and rules established by the AMA (American Medical Association)

Resolve complex coding issues and perform root cause analysis

Evaluate coding trends and identify risk areas

Collaborate with outsourced vendors when appropriate

Underwriter Assistant at Zurich North America

February 2006 - January 2008 (2 years)

Ensured that the renewal file process was completed efficiently and effectively: processed renewal workups,

provided support to Field Underwriters by releasing quotes and issuing policies over $7million dollars.

Processed 20% of audits for my department, prepared new business accounts for underwriters from research

to releasing quote.

Provided system and operations training to new hires.

Accurately processed endorsements in a timely manner and sold additional products as upgrades.

Conducted monthly peer audits on all lines of business to ensure policies were booked and issued correctly.

Page2

1 recommendation available upon request

Materials Damage Adjuster at Nationwide Insurance

2006 - 2007 (1 year)

Determined proper policy coverage's, and where necessary, investigated, evaluated, negotiated and equitably

settled all assigned material/physical damage claims cases in accordance with company policies and

procedures at values commensurate with damages sustained.

Participated in preferred shop/direct repair shop claims management process.

Planned and executed all time schedules necessary to promptly and effectively conclude all assigned cases;

adhered to high standards of professional conduct commensurate with the delivery of superior service.

Authorized and/or approved all claim payments within the delegated authority or within the maximum limits

($5K) as outlined in company policies and procedures.

Assisted or prepared files for suit, trial, or subrogation.

Appraised quality and quantity of insurance claims for repairs and prepare reports.

Business Manager at Corinthian College, Inc

2004 - 2006 (2 years)

Promoted to multi -functional position encompassing the full range of accounting skills and office

management of a four member accounting and clerical staff, which included collections, customer service,

purchasing, commercial loans, accounting, and inventory management.

Controlled daily operations in an extremely busy office. Developed and modified operational procedures to

accurately account for a million dollars in monthly funds in the form of grants, government and commercial

loans.

Balanced financial reports and journals; reconciled and analyzed cash receipt journals and bank accounts;

processed payments; accessed all accounts to make deposits, withdrawals and fund transfers.

Sr. Utilization Account Manager at PRIUM Medical Cost Management

2003 - 2004 (1 year)

Assisted in the development, coordination and implementation of the company’s first Return on Investment

report.

Conducted clinical reviews prior to a claimant’s episode of care in the form of pre-authorizations.

Provided guidance for financial impact of the clinical operational aspects of the Peer Review and Utilization

Review programs, i.e. Case Management, Concurrent Review and Retrospective Review in accordance with

the Georgia State Board of Worker’s Compensation guidelines.

Handled medical records in accordance to URAC standards.

Assistant Public Relations Manager at Hartsfield Jackson International Airport

1998 - 2001 (3 years)

Sr. Speech writer for the General Manager and other high profile management positions at the airport.

Editor of the Hartsfield Atlanta Airport Magazine.

Primary writer for all communications.

First responders to TV and print media request for information.

Page3

Managed two Information Officers.

Languages

English (Native or bilingual proficiency)

Arabic (Elementary proficiency)

Haitian Creole (Elementary proficiency)

Skills & Expertise

EMR

Healthcare

Hospitals

Clinical

Health

Speaking engagements and speech writing

Press release writing and distribution

Technical Writing

Community Outreach

Medical Coding

Clinical Research

HIPAA

CPT

ICD-9

EHR

Medical Records

Healthcare Management

Software Documentation

Training

Medicaid

Data Entry

Customer Service

Informatics

Epic Systems

Medical Billing

Medical Terminology

Leadership

Medicare

Outlook

Revenue Cycle

System Administration

Invoicing

Health Information Management

ICD-10

Healthcare Information Technology

Practice Management

Access

Page4

Insurance

Analysis

Accounts Receivable

Health Insurance

Healthcare Consulting

Interviews

Policy

Human Resources

Data Analysis

Physicians

Meditech

Time Management

Management

Education

DeVry University

Associate Degree, Health Information Technology, 2011 - 2012

Georgia Southern University

Bachelor of Science, Communication Arts, 1991 - 1996

Activities and Societies: Student Government Association, Residence Hall President, Pi Sigma Epsilon.

Interests

Internships, consulting offers, new ventures, job inquiries, business deals, getting back in touch

Page5

Dwayne C, BS, RHIT

Health Information Pro looking for a new opportunity

acazfu@r.postjobfree.com

1 person has recommended Dwayne

"It was great experience working with Dwayne during my service with Zurich North America. Dwayne

played a very special role as Assistant Underwriter that added great value to the integrated of our business

unit. He maintains creativity, enthusiasm as well as a sense of good judgment graced with patience. He has

the skill and dedication to the overall "big picture" to make him an asset to any company."

Ben Jones III MBA, Regional Director Enterprise Support Operations, Zurich North America, managed

Dwayne at Zurich North America

Contact Dwayne on LinkedIn

Page6



Contact this candidate