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Health Information Service

Location:
Lakewood, NJ, 08701
Posted:
January 22, 2017

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Resume:

JESSICA ARROYO

* ********* ***** ********, *** JERSEY, 08701 732-***-**** ********@*****.***

PROFESSIONAL SUMMARY

Dedicated Registered Health Information Technician with six years of acute-care 300+ bed hospital, medical records supervisor experience, population health management and provider relations experience within a health services platform. Highly motivated self-starter with expertise in record analysis, abstracting and auditing; as well as assisting in improving clinical outcomes, desires a position in clinical documentation. Seeking opportunities in management or revenue cycle within healthcare.

CREDENTIALS AND LICENSES

Registered Health Information Technician (RHIT), New Jersey

Issued April 2014 by American Health Information Management Association (AHIMA)

Certified Risk Adjustment Coder (CRC), candidate – exam date February 20th, 2017

American Academy of Professional Coders (AAPC)

PROFESSIONAL EXPERIENCE

UNITED HEALTHCARE (UNITED HEALTH GROUP), ISELIN, NJ

Provider Relations Advocate, Jul 2016 – Present

Train & develop external provider education, ease of physician portal and future service enhancements.

Design and implement programs, build positive relationships with providers and practice managers.

Direct and implement strategies relating to development and management of provider network.

Identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs.

Work end - to - end provider claim and call quality.

Remediate operational short-falls and research and remediate claims.

OPTUM (UNITED HEALTH GROUP), ISELIN, NJ

Healthcare Services Coordinator, Population Health Management

(Medicare practice based support/Telecommute), Jul 2015 – July 2016

Reviewed available member service records and relevant documentation (utilization history, functional level, stratification, current plan of care).

Researched member-related health information (e.g., medications, clinical records, policies, benefit information) using internal and external systems.

Conducted comprehensive member assessment that includes bio-psychosocial, functional, and behavioral health needs.

Collaborated with providers to strategize on identifying gaps in care for our Medicare Advantage population (achieve quality STARS ratings), and drive successful outcomes.

Ensured that providers are meeting their metrics and assigned quality measures based on their performance agreements.

Identifed when supplemental assessments were needed and conducted supplemental assessments.

Integrated health care and service needs into a plan or recommendation for member care and service.

Monitored progress toward plan goals through evaluation of the effectiveness of programs and/or services provided Produced changes to plans or recommendations based on evaluation outcomes.

Coordinated Healthcare Effectiveness Data and Information Set (HEDIS) collection strategy for market.

MONMOUTH MEDICAL CENTER, LONG BRANCH, NJ

Records Completion Coordinator, Health Information Management, Jan 2010 – Jul 2015

Coordinated workflow and assign duties to staff in the record completion area.

Carefully reviewed medical records for accuracy and completion as required by JCAHO standards.

Conducted quantitative audits, re-analysis of records, compiled audits of data to present to Director.

Management of policy and guideline updates.

Identified error trends relating to medical record documentation while assisting in best practice.

Facilitated monthly and annual training of EHR system (Cerner and 3M) while providing physician liaison support to attending physicians and residents.

Provided inter-facility training on EHR, to HIM staff.

Retrieved physician correspondence from dictation service, assign to medical record, make edits when necessary.

Verified proper interfacing of records between systems.

VALLEY NATIONAL BANK, SOUTH ORANGE, NJ

Branch Service Manager, Dec 2002 – Oct 2008

Implemented annual performance appraisals for all branch staff.

Actively recruited and oversaw training for all new branch employees.

Managed daily branch operation, prepared periodic reports, and performed required audits.

Educated customers on the variety of loan products and available credit options.

Provided team building support to Sales Manager to assist in achieving branch goals.

ADDITIONAL SKILLS

EHR software: Cerner Millennium/Power chart, Allscripts, e-ClinicalWorks, 3MHIS, 3M encoder, Affinity

Advanced computer proficiency: Microsoft Office(Access, Excel, Outlook, Power Point, Word), Citrix XenApp-remote system, WebEx, Facets, NDB, Cosmos, Emptoris, Impact, Phycon

Clinical data analysis and abstraction

Good oral and written communication

Inter-facility training

HIPAA compliance

ICD-9-CM, ICD-10-CM proficient

HEDIS/CMS Stars Ratings

Provider Relationship experience

EDUCATION

BROOKDALE COMMUNITY COLLEGE, LINCROFT, NJ

A.A.S./Health Information Technology, Graduated May 2013

THOMAS EDISON STATE UNIVERSITY, TRENTON, NJ

B.S./B.A. Hospital Healthcare Administration, Expected graduation 2018

RELEVANT COURSEWORK

Medical Terminology

Anatomy and Physiology

Disease Pathology

Healthcare Informatics

ICD-10 CEU sponsored by AHIMA: ICD-10 Impacts Medicare Advantage Risk Adjustment Payments, Getting started with ICD-10CM -what coders need to know now, Getting started with ICD-10PCS -what coders need to know now



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