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Hedis Abstractor/ Reviewer

Location:
Philadelphia, Pennsylvania, United States
Posted:
August 20, 2018

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Resume:

CARLA N HENNINGHAM

Phone: 215-***-**** Email: ac6qrl@r.postjobfree.com

Professional Summary: Ambitious Certified Healthcare Information Technician (CHIT), with 20 years of experience in the medical field, strong medical terminology background, extensive EMR knowledge and well versed in Core and HEDIS measures.

Skills

HEDIS & Core Measures

EHR Meaningful Use

NCQA & CMS Standards

Critical Thinking Skills

Medical Terminology

Microsoft Office

HL-7 Standards, SQL, QSHR, Vendor HEDIS Software (Altegra)

Allscripts, Centricity, Cerner, Epic, EClinicalWorks, Salesforce

EDUCATION & CERTIFICATIONS

Jefferson University – Bachelor of Science in Information Technology Management

Bucks County Community College – Health Information Technology Certification

Community College of Philadelphia - Associates of Arts in Culture, Science, & Technology

PROFESSIONAL EXPERIENCE

Medical Records Field Abstractor/ Reviewer

Traveled to various medical facilities and hospitals in the Pennsylvania, New Jersey, and Delaware area, to retrieve medical chart information from EMR and/ or paper charts for CMS Stars, or HEDIS audits.

Reviewed HTA, Scanned, and uploaded documents to the corporate data center (OnBase) for further review.

Researched pends via Facets, Updated vendor database.

Input relevant clinical data into abstraction software such as ChartNet & QSHR, in accordance with the HEDIS guidelines for insurance companies such as Health Partner, Aetna BH, and United Health Group.

Abstracted and processed approximately 60+ charts daily with multiple HEDIS measures.

Patient Service Representative

Achieved high performance evaluations for call handling ability and quality of services provided to patients in a fast pace, high volume call center.

Assisted patients with appointment scheduling, insurance related questions, as well as patient request documents and finds under patient profile using Salesforce and Epic.

Resolved problems or escalated to managers as needed.

Office Assistant

Scheduled appointments and completed basic accounting and payroll reports.

Completed all data entry & filing for documents including billing receipts and orders.

Placed orders, stocked material and distributed parts, tools, and office supplies.

Converted and implemented QuickBooks and Fishbowl to maximize efficiency.

Electronic Medical Records Trainer\ Nursing Assistant

Provided classroom and ATE support for physicians, nurses, and fellow staff members; served as a point of contact for questions, issues, and updates regarding the software, post Go-Live.

Created training material for classroom sessions and new hires, analyzed and redesigned workflows as needed.

Documented logs, tracked and issued resolutions as per protocol. Frequently used SQL queries to search and analyze patient data from server, documented findings, reported to Project Manager.

Patient Care

CARLA N HENNINGHAM

Phone: 215-***-**** Email: ac6qrl@r.postjobfree.com

WORK HISTORY

TotalMed LLC., (United Healthcare Group), Iselin, NJ – Medical Records Reviewer Dec 2017 – April 2018

ChartPros LLC., Plymouth Meeting, PA – Medical Records Reviewer Jan 2017 - May 2017

Medisys Solutions, LLC., King of Prussia, PA - Medical Records Field Abstractor/Reviewer Feb 2016 - Apr 2016

Unique Advantage (Penn Medicine), Philadelphia, PA - Patient Service Representative Jun 2015 - Jan 2016

Enterprise Consulting Solutions, NJ, PA & DE - Medical Records Field Abstractor Aug 2014 - May 2015

Ogontz Glass and Mirrors, Philadelphia, PA - Office Assistant Sept 2012 - Jul 2014

Peninsula General Hospital, Far Rockaway, NY - EMR Trainer\ CNA Dec 2008 - Feb 2012

References available upon request.



Contact this candidate