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Medical Customer Service

Location:
San Francisco, CA
Posted:
December 19, 2014

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Resume:

Jocelyn Kizine

**** ******** *****, **** *, Sunnyvale, CA 94086

Home: 650-***-**** Cell: 650-***-****

e-mail: acg3oh@r.postjobfree.com

OBJECTIVES

To obtain a position that effectively employs my extensive experience and training and provides opportunity for

expanding my knowledge and skills, with goals of further advancement.

EXPERIENCE

Excite Health Partners to Lucille Packard, Menlo Park, CA June 2014 – Present

Medical Record Abstractor

• Performs medical records abstraction in support with the Stanford/Lucille

Packard Children IT Staff

• Accurately transfer PHI information from eCW, Athena Database and enters the results of chart audits into the

EPIC database. Abstracts medical record information and enters data with appropriate tools.

• Makes determinations on records and refers records for clarification when needed.

Bayside Solutions to Health Plan of San Mateo County, San Francisco, CA Feb 2014 – April 2014

HEDIS Abstractor

• Performs medical records abstraction in support of annual preparation for

Fiscal Compliances audit for The Healthcare Effectiveness Data and Information Set

(HEDIS) for State and Federal Government contract.

• On an annual basis develops expertise in the requirements and parameters of

mandated External Accountability Set (EAS) performance measures.

• Applies structured auditing criteria to medical records to determine

compliance with standards of the EAS.

• Maintains productivity level as determined by the Quality Improvement

Manager and Medical Director.

• Accurately enters the results of chart audits into a database (e.g. Quality

Reporter).

• Monitors progress towards completion of the annual HEDIS chart

abstraction process.

• Maintains a less than 2% error rate in record abstraction and data entry.

• Utilizes various software applications (e.g. Quality Reporter, Excel and

Word) to support HEDIS operations.

• As required: visits to provider sites to identify copy and collect selected

medical records.

• To support Health Plan of San Mateo’s (HPSM) efforts to collect performance measure data.

• Reviews medical records for compliance with NCQA®, DHCS, DMHC, CMS, and other regulatory

agencies.

• Medical chart data collection from provider offices and/or abstraction from medical records received by fax or

mail.

• Makes determinations on records and refers records to the clinical lead for clarification when needed.

• Abstracts medical record information and enters data on appropriate tool.

• Attend periodic team meetings to discuss current status of each measure and project status.

• Identification of other potential providers of service based on initial medical record review.

• Participate in HEDIS® team meetings

• Establish and maintain effective interpersonal relationships with all levels of staff, agencies, members, providers

and the general public.

• Participates in medical record inter-rater activities as required

Collaborative, LLC to AbbVie (Abbott Laboratories), Redwood City, CA June 2013 – Sept 2013

Sr. Document Control Specialist

• Process changes using Agile system and responsible for the implementation and maintenance of SOP, reviewing,

analyzing and change control documents in a regulated environment IT Department.

• Defining procedures to retrieve from a local document control system and converting into a PDF file and copied

and data entered to another shared control system.

• Organize document by department function and/or author.

• Controlling and monitoring users of their accountable for all actions performed under their login including access

to, or submission of electronic documents.

• Monitoring Users to ensure that passwords are maintained as confidential information under the control of

Electronic Document Management System (EDMS) Administrator.

• Update, Archive, Maintain, Monitor, Revise, Release, Implementation, Distribution of Quality Documentation

and Procedures, applicable and related to Quality System Regulations.

Allscripts to El Camino Hospital, Mountain View, CA March 2012 – May

2013

Record Retrieval Specialist

• Primary responsibility is to verify and retrieving confidential records, ensuring and analyzing proper Release of

Information and Documentation of In-Patient/Out-Patient Medical Records in Compliance with the JCAHO,

FDA/CFR Title 22 and El Camino Hospital Regulations.

• Customer Service Liaison, helping and Supporting Medical Facilities/Clinics, Legal

Services/Attorneys/Subpoenas, Client Copy Services, State(s) Department of Social Services/Disabilities, CMS,

HEDIS, RACs, Risk Manangement, Health Advocate, Insurance Companies in Completion of Authorized

Patient’s Release of Health Information such as ER Notes, Physicians Notes, Nurses Notes, History and Physical,

Operative/Surgical Report, Discharge Report, Patient Progress Report, Clinical Labs and Test Data Report,

Radiology Report, Admissions, Anesthesiology Report and Outside Records using Database/Server.

• Responsible for Approving, Processing, Electronic Scanning, Uploading, Printing & Releasing required records

requested by an individual or Patients.

• Retrieve confidential medical information as well as Electronic Medical Records, ensuring the proper release to

various clients.

• Verify that all medical records are in Compliance with the El Camino Hospital, HIPPA, JCAHO, FDA/CFR

Title 22 Regulations.

HealthPort, INC (Formerly, UNIVERSATA, Inc.) to STANFORD UNIV. MED. CTR, Redwood City,

CA March 2010 – February 2012

Record Retrieval Specialist

ScanSTAT, INC./STANFORD UNIV. MED. CTR., Redwood City, CA Jan. 2010 – February

2010

Medical Records/ ROI Retrieval Specialist (Contract)

Recommended by Stanford HIMS Director for UNIVERSATA, Inc. when Contract is over at ScanSTAT, Inc..

• Primary responsibility is to verify and retrieving confidential records, ensuring and analyzing proper Release of

Information and Documentation of In-Patient/Out-Patient Medical Records in Compliance with the JCAHO,

FDA/CFR Title 22 and Stanford University Hospital Regulations.

• Customer Service Liaison, helping and Supporting Medical Facilities/Clinics, Legal

Services/Attorneys/Subpoenas, Client Copy Services, State(s) Department of Social Services/Disabilities, MS,

compliance with the Stanford University Hospital, CMS, HEDIS, RACs, HIPPA, JCAHO, FDA/CFR Title 22

Regulations.

• Increased team productivity by 10% through efficient value trends and procedures

• Reduced call wait times to 2 minutes by adapting new procedures and time management.

• Assisted customers and agencies in difficult situations, resulting in continued business and satisfied clients

MEDICALS & SURGICAL VISION CARE, INC., Santa Clara, CA Nov. 2009 -

Jan. 2010

Academic Student Externship

• Using NextGen/Medisoft Database, Physical billing and coding for Patients Services, monitor SuperBill to

different Insurance Companies.

• Maintained and Organized Medical Records, File Authorization and Release of Informations, Insurance Billing,

Consent Forms, New Release Records, New Patients Record Forms.

• Scheduling Patients to be seen by the Physician, as well as, Surgery schedules.

INSTITUTE FOR BUSINESS AND TECHNOLOGY, Santa Clara, CA Oct. 2009 – Nov. 2009

Career Service Assistant

• Administrative Assistant such as monitoring Graduate Students Academic and Job Status, Confirmation of Job

Status/Records, Record Management, Filing correspondence, Interactions and Assist Student's questions and

concerns, Answer phone lines in daily basis.

ULTRA CLEAN TECHNOLOGY, Menlo Park, CA Oct. 2007 – Feb. 2008

Document Control Engineering Support Analyst (Recalled-Permanent)

Document Control Engineering Support Analyst (Contract) Feb. 2007 – July 2007

• Ensured that documentation projects meet established Quality Standards, Good Manufacturing and Clinical

Practices and on-time deliveries. Coordinates with engineering, production, and other departments in providing

document control services.

• Maintain documentation for external regulations or procedural guidelines such as ISO-9000 standards.

• Update, Maintain, Monitor, Revise, Release, Implementation, Distribution of Quality Documentation and

Procedures, applicable and related to CAPA.

• Process documentation changes in Agile and ensures that product and product related documents are processed

through the Agile database in compliance with established procedures

• Responsible for maintaining and continuously improving the Document Control Quality System through the

Agile database in compliance with established procedures

• Train and ensuring the understanding of all quality process and SOPs to various Department.

• Monitoring and maintain Bill of Materials for Production Control. Each part no. that has a unique no. must

correspond to a drawing no.

• Support the inventory control all the necessary information for each particular parts on the Bill of Materials and

must contain a unique no. or part no and should have the following attributes:, e.g, a unit, lb, kg, m, m , hours,

suppliers, assemblies and sub assemblies must contain a unique no., would contain either a raw material or a

BOMs.

• Validating and Preventing errors getting into bill of materials, inclusion of mandatory data and prevention of

incorrect data for the quantities.

NOVOSTENT, Mtn. View, CA July 2007 – Oct. 2007

QA Document Control (Contract)

PAVAD MEDICAL, INC., Fremont, CA Feb. 2006 – July 2007

QA Document Control (Contract)

CLONTECH LABORATORIES(Formerly BD BioScience), Mtn. View, CA Oct. 2005 – Feb. 2006

QA Associates (Contract)

(all above companies have similar responsibility):

• Responsible for the review, release, and distribution of Product Technical Documentation.

• Responsible for the Implementation of Documentation changes due to Engineering Change Notices (ECNs).

• Train individual and ensuring the used and understanding of all Quality Process and Standard Operating

Procedures to employees.

• Update, Maintain, Monitor, Revise, Release, Implementation, Distribution of Quality Documentation and

Procedures, applicable for production processing and engineering used.

• Responsibilities include approval, issuance and reviewing of batch records.

• Reviews batch documentation for accuracy and completeness according to cGMPs, QS Regulations.

• Conducts QA review in-person and activities including, area Approval, line clearance approval, record eeview,

deviation triage, preliminary and assists with the deviation investigations

• Compliance investigations, and Customer complaint investigations.

• Supports implementation of CAPAs, SOP revisions, Quality improvement initiatives, Operational projects, etc.

• Adheres to internal/external Guidelines, Specifications and Regulatory requirements while reviewing batch

documentation.

• Ensures all GMPs, SOPs and protocols are followed.

• Positively interacts with internal associates to quickly and effectively resolve issues.

• Addresses deficiencies and ensures completion of follow-up actions

• Maintaining consistent resolutions to batch review issues according to GMP standards and Client objectives.

MILLS-PENINSULA HOSPITAL (Sutter Health), Burlingame, CA Feb. 2003 –

Oct. 2005

Senior Medical Record Analyst (Per-Diem)

• Primary responsibilities are ensuring and analyzing proper Released and Documentation of In-Patient/Out-Patient

Medical Records for proper Incorporating of records to the Database and release in Compliance with the

JCAHO, CFR Title 22.

• Various responsibility which includes analysis (in-patient & outpatient records), doctors liaison, data entry,

records maintenance, completions of Doctors delinquencies, filings, answering calls from physician(s) and

patient(s).

STANFORD UNIVERSITY MED. CTR., Palo Alto, CA June 2002- Feb. 2003

Medical Records Analyst (Contract)

• Primary responsibilities are ensuring and analyzing proper released and documentation of In-Patient/Out-Patient

Medical Records in compliance with the JCAHO, FDA/CFR Title 22 and Stanford Medical Regulations. Helping

and Supporting Physician in completion of their documentation delinquencies such as Physicians Signatures,

History and Physical, Operative/Surgical Report, Discharge Report, Patient Progress Report, Clinical and Test

Data Report, Admissions, Anesthesiology Report and Outside Records.

TRAINING/CERTIFICATION:

• ISO 9001 Internal Auditor Certificate (San Jose State University)

• Quality System/FDA Regulation 21/22 CFR 820 Certificate

• Document Structure, Document Data Control and Maintenance

• Good Clinical and Manufacturing Practices Training/ Statistical Process Control Certificate

• Total Quality Management Certificate

• Solidworks 2000 Certificate

SOFTWARE/DATABASE/TECHNICAL SKILLS:

Microsoft Window Vista, XP, ME, 2000, 90s, Excel/Spreadsheets, Outlook, QAD, Adobe Acrobats/Adobe Illustrations,

Page/File Maker Pro, Documentum Database, LiveLink (Electronic Record Management), Imaging,

CITRIX,HYLAND/EPIC, Legacy CareCast Database, SmartLink/SmartLog, Quark X-Press, Access Management,

Solidworks2000/PDM Data Management, BAAN IV, Pro-E, Visio99, ProWrite, Activault, IDX, Deliverex, AGILE

Database, MAN-MAN, EPIC, Medisoft, Legacy, e-DocCompliance 2004 (Remote)

EDUCATION:

Ultimate Medical Academy – Clearwater, Fl April 2013 – Current Student

A.S Healthcare Management

Institute for Business and Technology - Santa Clara, CA Graduated Spring of 2010

Diploma, Medical Billing/Coding/Office Specialist

San Jose State University - San Jose, CA Graduated Spring of 1996

ISO9000 Auditor

Perpetual Help College - Manila, Philippines Graduated 1975

LVN License

State of California Certified 1980

Certificate Nursing Assistant



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