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Medical Customer Service

Location:
Portsmouth, VA
Posted:
September 08, 2018

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Resume:

JACQUELINE J CUPID

P.O. BOX **, SMITHFIELD, VA **431 H: 757-***-**** C: 757-***-****

ac6yzt@r.postjobfree.com

PROFESSIONAL EXPERIENCE

Southeastern Virginia Training Center 6/2018 – current

Medical Services Coordinator/Assistant to Medical Director

ICD-10 coding of inpatient medical diagnoses necessary for referrals and continuity of care

Medicare and Medicaid billing

Scheduling patients’ outpatient appointments.

Responsible for assisting with organizing and distributing all incoming and outgoing patient information.

Copy, mail, and/or fax patient chart information as requested and authorized.

Assist in preparing and filing all internal and external correspondence and medical reports into patient medical record according to filing system.

Maintain current ID notes.

Record new patient appointments and retrieve appropriate information from treating physicians and hospitals.

Work closely with pharmacy, HIM and nursing departments on patients’ treatment and to ensure completion of inpatient records.

M*Modal 10/2017 – current (Level 3 Healthcare Documentation Specialist)

Nuance Transcription Services 11/2014 – 05/2015

TransTech Medical 9/2012 – 12/2012

Transcription, Ltd/MedQuist Transcription, Inc. 9/1997 – 6/2004; 3/2007- 8/2011

Outsourcing Solutions, Inc. (currently Nuance) 2/2006 – 6/2007; 7/2010 – 11/2010

Transcription Solutions, Inc./SmartMed (company no longer in business) 4/2002 – 7/2004

Med-Systems Associates 7/1997 – 9/1998

Riverside Regional Medical Center 4/1994 – 8/1996

Level-2 Medical Transcriptionist/Medical Editor (Above employers)

Interpreted, transcribed and edited dictated emergency room and acute care and various specialty and ancillary care documents according to guidelines, standards of style, and formats of practice to provide a permanent record of patient care

Demonstrated an understanding of the medicolegal implications and responsibilities related to the transcription of patient records to protect the patient and the business/institution

Operated designated word processing and transcription equipment as directed to complete assignments

Expanded job-related knowledge and skills to improve performance and adjust to change

Used interpersonal skills effectively to build and maintain cooperative working relationships

Performed post-transcription document review and correction

Maintained documentation integrity and a 98-100% error-free rate, achieving entry to the 100 club at Outsourcing Solutions, Inc. Promoted to Master Medical Editor at MedQuist in 2009.

Adhered to policies and procedures to contribute to the efficiency of the medical transcription department

OBICI Hospital 1/1991 – 3/1994 168 bed

Medical Record Technician

Compiled and maintained medical records of patients in health care delivery system to document patient condition and treatment.

Performed clinical documentation improvement according to healthcare and coding regulations.

Reviewed medical records for completeness, as well as abstract and code clinical data using standard classification systems for acute care facilities including outpatient and inpatient coding.

Analyzed data, compiled medical care and census data for statistical reports.

Interpreted hospital rules and regulations relating to hospital admission, patient transfer, ER services and outpatient services.

Release of medical information by responding to requests medical and legal entities and coordinated the resolution of medical-legal problems according to policies, procedures and regulations.

Responded to patient and other administrative inquiries

Maintained and utilized a variety of health record indexes, storage and retrieval systems

Ensured and safeguarded Patients’ rights

Operated computer to process, store, and retrieve health information

Advised and worked with physicians regarding coding practices, requirements, MR completeness, policy and procedures; and maintained open communication with physicians to ensure satisfaction and compliance with set standards

Practical knowledge of medical record documentation and medical procedures/diagnosis for medical records completeness and audits

AMI Single-Day Surgery 12/1989 – 04/1990

HCA Northwest Regional Hospital 10/1988 – 11/1989 – 228 bed

Medical Record Technician (Medical Record Supervisor at AMI)

Compiled and maintained medical records of patients in health care delivery system to document patient condition and treatment.

Performed clinical documentation improvement according to healthcare and coding regulations. Code and abstract medical records for completeness using the clinical data according to standard classification systems

Analyzed data and compiled medical care and census data for statistical reports on types of diseases treated, surgery performed, and use of hospital beds as requested by state agencies

Maintained and utilized a variety of health record indexes, and storage and retrieval systems

Performed release of medical information according to policies, procedures and regulations

Ensured and safeguarded Patients’ rights

Responded to patient and other administrative inquiries

Advised and worked with physicians regarding coding practices, requirements, MR completeness, policies and procedures; and maintained open communication with physicians to ensure compliance with set standards

Monitored and ensured staff performance

Performed physician credentialing

Practical knowledge of medical record documentation and medical procedures/diagnosis for medical records completeness and audits

Cigna Insurance 9/1986 - 5/1987

Medical Claims Specialist

Documented medical claims

Processed and adjudicated claims, assigned benefits by requesting appropriate medical information

Ensured legal compliance by following company policies, procedures, guidelines, as well as proprietary state and federal regulations

Maintained quality customer service by following customer service practices and procedures; responding to customer inquiries

Harvard University Health Center 7/1985 – 5/1986

Office Manager (Physicians)

Scheduled appointments

Checked patients in and out

Responded to patient and other administrative inquiries

Created claims for third-party payment

Created patients’ bills and collected payments

Updated patients’ personal and insurance information

Coded procedures and diagnoses, and billed insurance companies

Reviewed medical records for completeness according to policies, procedures and regulations

Ensured and safeguarded Patients’ rights

Conferred with physicians regarding appropriate diagnostic and surgical codes

USAF Hospital Tyndall 11/1978 – 4/1983

Certified Medical Administrative Specialist/Health Services Management – Journeyman

Resource management - Coordinated and submitted payment for charges for medical treatment provided to active duty personnel by civilian healthcare facilities and providers, performed required procedures for network referrals and medical appointments, performed audits for report of patients, input data on budget forms and presented budget to committee, prepared monthly reports, processed claims for payment to community healthcare providers/facilities. Analyzed and evaluated and/or coordinated health care delivery systems and operations which encompassed command, administrative, and logistics supporting the provision of health care to authorized beneficiaries.

Implemented efforts to improve systems and processes affecting the integration of multiple healthcare disciplines, e.g. (process improvement, risk management, patient safety, utilization review and credentialing and privileging).

Performed administrative functions – answered phones, interacted with patients – answered questions, assisted in completing forms, provided information, scheduling appointments, greeting patients, performed release of information of patients’ health information, entering patient data into computers, scheduling follow-up treatments, routed paperwork for admission, discharge, and transfer of patients

Responded to patient and other administrative inquiries

Coded, abstracted and completed inpatient and outpatient medical records, performed clinical documentation improvement according to healthcare and coding regulations - achieved the Air Force Good Conduct medal and Unit Airman of the Month

Analyzed and compiled data and charts for utilization review/management, and case management review; provided information from data analysis and created healthcare reports for the hospital unit and TAC Headquarters

Researched federal rules and regulations to assist in providing the guidance necessary to meet the procedures, and administrative and legal requirements related to patients’ care and treatment

Researched and complied charts for Tumor Registry committee and/or physician review, and followed up TR patients

Initiated, maintained, safeguarded, and retired inpatient and outpatient medical records; file and charge out medical records, screen and file forms in medical records, prepare outpatient records for physicians and clinics, maintain patient locator and suspended files

Physician credentialing

Interpreted and transcribed medical documents

Prepared and compiled clinical documentation for audits and hospital accreditation according to policies and procedures

Prepared documents for patient transfer/aeromedical evacuation

Evaluated, tracked and processed requests for release of medical information

Advised physicians on medical records coding, completeness, requirements, policy and procedures; and maintained open communication with physicians to ensure satisfaction and compliance with set standards

Practical knowledge of medical record documentation and medical procedures/diagnosis for medical records completeness and audits

Managed medical information technology functions

As CQ, processed administrative issues surrounding patients’ deaths, severely ill patients, patients’ medical evacuation and emergency Codes

As CQ, provided administrative guidance and advice to the Medical Officer of the Day, ER and other medical staff, concerning administrative matters required for operation of the hospital after normal hours

Adhered to policies and procedures to contribute to the efficient operation of the department, the unit and the Air Force, and safeguarding and ensuring Patients’ rights

SKILLS

Knowledge of and experience with ICD-9, ICD-9-CM, CPT, HCPCS, SNOMED, MS-DRG; healthcare laws, as well as HIPAA compliance, JCAHO accreditation, CMS regulations, FWA. Cener EMR. ICD-10-CM and ICD-10-PCS training via WHO site. Familiar with HEDIS/NCQA quality measures. Knowledge of project management, (PMBOK), data warehouses. Meditech, EditScript v11, eScription, DocQspeech, DocQscribe, EXtext Word Client, Dictaphone, Fluency Editor and Manager, AAMT BOS Style, Microsoft Office Suite, Prezi, Tableau. Data analysis using R (Chi square, Z test, T-test, ANOVA, linear regression), Excel (pivot tables), and MySQL query and code. Query relational databases, ERD, data flow, data cleanup, data mining, general computer skills, release of information, and scanning and imaging medical records.

Possess excellent skills in English usage, grammar, punctuation, style, transcribing and editing, oral and written communication skills, and strategies in interactions with consumers, peers, multidisciplinary and multi-facility professionals

Critical thinking, problem-solving

Ability to multitask, and detail oriented

Excellent team work, organizational and time management skills

Excellent research skills and can apply relevant legal concepts

Knowledge of healthcare data, information, and claims management

EDUCATION AND TRAINING

HIMS Internship at Riverside Health System, HIMS Department – 2017 (Change management, Change control, Patient Identity, Legal medical record, Epic/iCare EHR, HIPAA compliance, ProVation interface, CIOX ROI, Epic POS scanning, Forms committee - Epic Scan Doc Crosswalk, Forms Swap (legacy - Epic), Department and High-level budget analysis including dept. payroll, Patient safety, Risk management, Patient privacy – vetting online companies requesting patient medical information, MR deficiency tracking, CDI and coding responsibilities, NIAHO/DNV accreditation requirements). RHS BSC.

Master of Science in Health Information Management - The College of St. Scholastica, Duluth, MN – 2017 (RHIA eligible)

The National Institutes of Health (NIH) Office of Extramural Research NIH Web-based training course "Protecting Human Research Participants", IRB Date of completion: 03/18/2016. Certification Number: 2035111

Bachelor of Science in Health Studies, Concentrations in Health Informatics and Healthcare Administration - Walden University, Baltimore, MD - 2014

Associates of Arts and Science, Science major - Paul D Camp Community College, Franklin, VA – 1998

Pharmacy, Health Careers Opportunity Program - Hampton University, Hampton, VA - 1997

Non-commissioned Officer Training - USAF Tyndall AFB, Panama City, FL - 1981

NCO Supervisory/Leadership Training – NCO Academy, Tyndall AFB, Panama City FL – 1981



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