PROFESSIONAL SUMMARY

EDUCATION AND TRAINING

SKILL HIGHLIGHTS

PROFESSIONAL EXPERIENCE

STEPHANIE M ALLEN

*** ******* *****, *********, ******* 30016 H: 678-***-**** acvq6m@r.postjobfree.com I'm looking to obtain a position that will enable me to use my 30 years of experience in the health industry), hospital, medical Records and leadership skills. Working with others as a team to achieve advancement and growth for the company is my goal. I am dependable, energetic, detail-oriented and proficient in medical terminology, anatomy and physiology. I have a documented track record of outstanding patient / physician support, adept at going above and beyond expectations and building lasting patient and provider rapports

1992 Certified Nursing Assistant

Career Technical Institute New York, N.Y.

DeKalb Technical College Certified Phlebotomist Clarkston, GA 2007 *Phlebotomy training completed at Grady Memorial Hospital

Staffing management ability

Proven patience and

self-discipline

Relationship and team building

Staff training and development

Conflict resolution

Patient-oriented

Personal and professional

integrity

03/2016 to 05/2016 HEDIS Remote Specialist

Molina Healthcare Charleston, SC

Worked remotely as a HEDIS Specialist

Abstracted medical records from Database

Abstracted positive and negative medical charts

Conducted QI audits for Medical Record Review

Matched Data with HEDIS measured Guidelines

Ensured medical records met standards defined by CMS

Assessed and corrected any errors in data as needed

Maintained confidentiality with Protected Health Information 09/2014 to 02/2016 MRA Southeast Region Frontline Lead Humana Inc

Skilled use of HEDIS software for data, over reading, QA queries Review medical records to ensure standards are met as defined by CMS

Identifies standards met and gaps against external auditor standards Conduct training for new hires and education to current employees Conduct additional QI audits through medical record review Conduct evaluation for direct reports

Approve pay and time off requests

Develop interdepartmental relationships to develop and execute initiatives to overcome identified barriers to achieving clinical quality bench mark

Ability to manage and meet deadlines

Travel as needed

Commit to confidentiality of patients and direct reports Educate physicians, RN's and other clinical employees in the office with regard to HEDIS/Medicare STARs requirement as needed Humana. 04/2012 to 09/2014 Retrieval Specialist

MRA Southeast Region

Created annual goals, objectives and budget and made recommendations to reduce costs. Contacting healthcare providers to request and obtain medical and billing documents via fax, mail & e-mail for claims processing.

Responsible for processing claims, communicating with medical providers and other office related functions (i.e. filing medical claims, etc.) Assisting the nursing staff in the medical claim audit process by requesting medical records and applicable documents from medical providers nationwide.

Providing back-up to Data Entry Travel up to 100% of the time to multiple sites, as well as driving to locations that require overnight travel for up to a week at a time.

Conduct Chart reviews abstracting the relevant information needed to our MRA coding team.

Scan, copy, upload records into a secure database Build relationships with the providers.

Educate the provider groups on correct documentation Schedule appointments and visits to physician offices in a timely, efficient manner to meet all deadlines.

HEDIS, RADV and end of year retrieval Educates Physicians, RNs and other clinical employees in the office with regard to HEDIS / Medicare STARs requirements, as needed.

01/2011 to 01/2012 Radiology Front Desk Clerk

Blackstone Resources Emory Orthopedic & Spine Center Atlanta, GA Welcome patients as they contact the center personally or by telephone, and explain the services available, payment categories, and billing procedures.

Schedule appointments; direct walk-in patients and emergencies as per established policies and procedures.

Answer all incoming calls and route them to the appropriate staff. Register all patients per registration protocols an collect all documentation.

Generate route slips for each patient, and assure that all services provided have been checked out properly.

Reviews and verifies patient coverage of insurance or other agencies and computes the charges to be paid by the patient. Collects deposits or co-pays/deductibles prior to the patient being seen by the provider per established policies and procedures. Inform patient of their outstanding balance, collect said balance, and issue cash receipt when monies are collected.

Work closely with Medical, Dental and Nursing staff to assure smooth patient flow and cut down on waiting time.

Work closely with the health promotion personnel and refer them to patients who did not keep their appointment for follow-up. Call and remind patient of his/her appointment.

Follow up on "no show" patients on a daily basis.

Communicate patient's problem/complaint to the office manager or his/her designee.

Other related duty as the job requires.

Verify X-ray Orders Assist Techs as needed.

01/2010 to 01/2011 Medical Records Retrieval Specialist Custom Staffing Inc. Humana Inc Atlanta, GA

Perform medical record content analysis to ensure compliance with requirements of the Medicare contract.

Prepare, scan, and stage for final distribution all medical records received into the Medical Record Review Department.

Analyze content of medical records to ensure compliance with Medicare contractual requirements for timeliness and documentation. Notify Supervisor of any deficiencies and refer to the Medical Records Review Coordinator for tracking.

Request medical records, enter information into database, and send follow-up letter to facility if records not received. Open, date stamp mail and distribute to appropriate department associate.

Prepare, scan, and perform review of scanned medical records to ensure that a quality reproduction has been made.

Distribute the medical records appropriately through the Department according to government contract requirement or appropriate request including to the National Quality Monitoring Committee (Maximus). Complete payment voucher and send to finance for processing; maintain file by hospital and copy service.

File medical records according to government contract requirements. Traveled to multiple medical facilities Reviewed medical records Medical coding exposure.

01/2008 to 01/2010 Unit Clerk

Grady Memorial Hospital Atlanta, GA

Helps patients by responding to intercom requests; obtaining needed services from nurses, licensed practical nurses, physicians, aides, and other hospital personnel.

Welcomes visitors by greeting visitors, in person or on the telephone; answering inquiries; relaying calls to patients; giving directions; referring inquiries to nursing and physician staff.

Provides information by answering questions and requests. Establishes patient record by preparing folder; assigning patient number; completing patient identification information.

Documents patient care services by copying nursing and physician notes to patient and department records.

Arranges discharges by notifying business office and patient transporter service.

Maintains unit operations by following policies and procedures; reporting needed changes.

Maintains patient confidence and protects hospital operations by keeping information confidential.

Maintains unit supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies. Keeps unit equipment operational by following manufacturer's instructions and established procedures; calling for repairs. Conserves unit resources by using equipment and supplies as needed to accomplish job results.

Secures patient information by completing data base backups. Maintains safe and clean working environment by complying with procedures, rules, and regulations; adhering to infection-control policies and protocols.

Maintains continuity among work teams by documenting and communicating actions, irregularities, and continuing needs. 01/2006 to 01/2008 Sr. Health Info Mgmt. Tech

Grady Memorial Hospital Atlanta, Georgia

Protect the security of medical records to ensure that confidentiality is maintained.

Process patient admission and discharge documents. Review records for completeness, accuracy and compliance with regulations.

Compile and maintain patients' medical records to documentation condition and treatment and to provide data for research or cost control and care improvement efforts Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedure and treatment into computer Release information to persons and agencies according to regulations.

Plan, develop, maintain and operate a variety of health records indexes and storage and retrieval systems to collect classify, store and analyze information Manage the department and supervise clerical workers, directing and controlling activities of personnel in the medical records department.

Transcribe medical reports.

Identify, compile, abstract and code patient data, using standard classification system Resolve/clarify codes and diagnoses with confliction, missing or unclear information by consulting with doctors or others to get additional information and by participating in the coding teams regular meetings.

Train medical records staff.

Assign the patient to one of several hundred diagnosis related groups, or SKILLS

REFERENCES

DRG, using appropriate computer software.

Schedule appointments, back-up, balance, billing, clarify, clerical, CMS, consulting, copying, Data Entry, data base, diagnosis, directing, documentation, driving, e-mail, external auditor, fax, filing, finance, insurance, inventory, notes, Medical coding, Review medical records, Medical Record Review, meetings, mail, office, patient care, patient flow, personnel, Phlebotomy, policies, protocols, reading, reporting, requirement, research, Supervisor, telephone,

* References Upon Request

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