Vicky Bethel

Medical Records Coordinator

Beaumont, TX 77713

ad4bdj@r.postjobfree.com

+1-409-***-****

Medical Records Coordinator with over 20 years’ experience in records management which relates to every angle of patient care. Detail oriented in release of information, EMR systems, medical billing, medical terminology, HIPAA compliance, HEDIS and Risk Adjustments, ICD-10, communicating, organizing and problem-solving.

Education

AAS Applied Science in Health Information Technology Lamar Institute of Technology - Beaumont, TX

January 2009 to May 2012

Work Experience

TPL Denials Management Analyst

Contract Oct. 19 - Dec. 6, 2022

Pyramid Consulting Contract with Accenture

Reclamation billing for Medicaid, reclaiming payments made by Medicaid from carriers in the 13 Colonies of the east. Examining the error messages on the EOB's after deciding which claims can be recovered. Speaking with carriers to resolve the claims to receive payments. Resolving claims by reviewing coding processes for errors, requesting medical records or correcting erroneous submissions of the 1500 or UB04 claim forms which legally support the return submission to the carriers for reimbursement. CMS error messages are consistent which aids in the reclamation of funds. Timely executions of evaluations of the claims and medical records prominently produce monetary recoveries for the state of Massachusetts.

Release of Information Specialist

Arco Corporations contract with Evolent Health - Remote Contract - January 2022 to April 27, 2022

Supporting HEDIS and Risk Adjustments medical records requests utilizing excel and virtual networking to retrieve and deliver required data. Contacting hospitals, practices, and rehabilitation facilities via Outlook and Microsoft Teams to schedule medical records requests; prior to record splitting, creating PDF files, and uploading HEDIS and Risk Adjustment records to websites

Customer Service Representative

Mindlance contract with Anthem Blue Cross Blue Shield - Richmond, VA, CA, UT and New England States Contract - October 2021 to January 2022

Answering calls for New England States, California, Nevada, and Virginia Researching policy information and providing agents with eligibility benefits for members Verifying medical billing and claims to assist callers with their policies, coverage, claims, HSA, HRA, FSA, assorted benefits. Filing and correcting claims’ errors and data mining to aid members in every way possible. Providing and assisting member with completing required forms. Contacting inter-company departments to assist members with billing issues

Scheduling appointments, establishing guidance by researching in-house programs fitting for critically ill. Processing policy payments and wellness benefits, website shadowing with members to provide higher quality online services. Providing thorough communications via Excel, Microsoft Teams, Word documents, and Outlook

Medical Records Field Reviewer Representing Insurance Companies Change Healthcare/Altegra/Outcomes – Alpharetta, GA Seasonal - January 2009 to September 2021

Reviewing patients medical records in physicians’ offices, hospitals and rehabilitation facilities Scanning and uploading created PDF files daily to patient medical records for Payment Integrity (PIA) and Healthcare Effectiveness Data and Information Set (HEDIS) Communicating via Microsoft Teams, Excel and Outlook to complete required contacts and remote transfers

Detailed auditing of patients’ medical records and physician practices Quickly applying newly acquired knowledge healthcare programs as encountered Assessing charts and the necessary documents within the specified time frame Reviewing medical records individually to confirm required documents are included as well as evident physicians notes indicating required patient care

Retrieving medicals records from Practice Fusion, Kareo, HBOC, ERV, Meditech, Epic, Athena, AdvanceMD, E-ClinicalWorks and other EMR Systems

Medical Support, Front Desk

Private Medical Practice – Beaumont, TX & Nederland, TX PRN – August 2018 to February 2021

Responsible for insurance and claims verification, billing, answering phone calls, release of information and medical records completion. Check in patients as well as call scheduled patients the day before appointments, calling the pharmacy, lab, medical billing and provider offices for various information for patients (referrals, authorizations, insurance queries). Completing Dr.’s messages and documenting calls. Other responsibilities as delegated.

Insurance verification and claims verification, billing and answering phone calls. Check in patients as well as call schedule, release of information and medical records completion. Calling the pharmacy, lab and provider offices for various information for patients (referrals, medical records, authorizations, medical billing and insurance queries). Completing Dr.'s messages and documenting calls. Other responsibilities as delegated.

Site Coordinator

HealthPort/Parallon - Houston, TX

Contract - June 2015 to December 2015

Managed the Fax and Billing Teams and trained new hires to become Release of Information Specialist. Releasing medical records for 19 Hospitals in Harris County Associates representing Parallon Corporation in Houston, Texas. Released medical records and medical billing records to lawyers, courts, physicians’ offices, continuing care entities, auditors and patients. Responsible for overseeing the day-to-day operations of release of information requests in a timely and efficient manner. Ensuring accuracy and providing customers with the exact time frame of medical records requested and customer service is a priority. Responsibly for correspondence, billing adjustments, logging records requests and destruction of records, answering phones, status checks, revising and creating reports, productivity, and anything else delegated.

Medical Records Coordinator

Queens Boulevard Extended Care Facility - New York, NY August 2013 to October 2014

Retrieve patient medical records for physicians, technicians or other medical personnel. Processing Release of information requests for patients, agencies and facilities. Responsible for data entry, MPI Indexes, clinics and IPRO appeals, according to regulations. Review medical records for completion, accuracy and compliance with regulations. Plan, develop, maintain, scan or operate a variety of PHI record indexes, records storage and retrieval systems to collect, classify, store or analyze information. New patient information, admissions/discharges, compile indexes, scan and maintain patients’ medical records to document condition and treatment and to provide data to needed entities. Manage hospice care documentation, identify, abstract and verify coded patient data, using ICD-9 and ICD 10. Resolve or clarify codes or diagnoses with conflicting, missing or unclear information by consulting with doctors or others. Entering physician orders and consultations; Compile medical care and census data for statistical reports on diseases treated; Develop in-service educational tutorials for employees; Prepare medical insurance billing; Managing time and attendance; Making appointments to release information to patients or family members. Also, managing the practical experience for students from Queensborough Community College, medical staff and new hires. Reimbursement Analyst

Pharmacy Healthcare Solutions/ Christus St Patrick Hospital - Lake Charles, LA May 2006 to July 2008

Processed claims for pharmaceutical drug recovery for 6 hospital pharmacies. Claims were bulk submissions for thousands of patients with medical records attached as proof of services. Filing claims and verifying with pharmaceutical companies for replacement shipping, site traveling, billing, ensuring physician participation by verification and signature. Faxing, answering phones, scanning patients medical records retrieved from Practice Fusion, Kareo, HBOC, ERV, Meditech, Epic, Athena, AdvanceMD, E-ClinicalWorks and more EMR Systems. Scheduled appointments with patients, pharmacy directors and doctors to ensure proper reimbursements are recovered for participating facilities. Making appointments to interview patients to document personal data to decide if the patients are eligible for governmental assistance when using approved reimbursable pharmaceutical drugs. Governmental Poverty Guidelines are the tools of decisiveness.

Release of Information Specialist

Advance Staffing - Beaumont, TX

January 2003 to December 2006

HIM Assistant/Office Assistant/Supplies/ Insurance Christus Dubuis - Port Arthur, TX

March 2001 to May 2003

Medical Records Clerk/Outpatient Assembly

Christus St Mary Hospital - Port Arthur, TX

January 1994 to March 2001

Skills Sets

Microsoft Office, Excel Spreadsheets, PowerPoints, Sharepoint, AWS, Teams, CMS, ROI, Joint Commission, AHIMA, HIPAA Tools, Safety and Security and Professional Communications with Patients, Family Members, Physicians, Staff and Business Entities