Data Entry Medical Records

Rebecca Wright

Kissimmee FL

Summary

Experienced Hedis Improvement Representative with 9 years of Hedis experience, dedicated to maintaining up-to-date standards of CMS AHCA guidelines and NCQA.

Proficient in coordinating information between departments and offices to enhance the quality of care provided to members.

Charted audit findings in Excel and relevant systems, ensuring accuracy and completeness.

Collaborated in reviews and quality record assessments to improve performance.

Worked on roles involving Protected Health Information (PHI) regularly in electronic and paper formats.

Scheduled and conducted internal audits to ensure adherence to quality standards.

Stayed current with guidelines and regulations in HEDIS to ensure compliance.

Accountable for Stars Quality rating for all offices, with responsibilities including data collection, abstraction, data entry, and performance improvement activities. Well-versed in various EMR systems such as ECW, Athena, Total Md charts, Aprima, and Amazing Charts.

Education

High School Diploma PSJA North Early College High School Pharr TX

Skills

HEDIS

Quality Improvement

Data collection

Abstraction

Data entry

Verify Benefit/Eligibility

Insurance verification

Authorization

Medical records

Documentation

Care Gaps

Quality care

EMR/Electronic medical Records

Professional Experience

Aegis Medical Group (United Healthcare) - REMOTE Jun 2021 - Jan 2024

HEDIS Improvement Representative

Maintained up-to-date standards of CMS AHCA guidelines and NCQA.

Coordinated information between departments and offices to enhance the quality of care provided to members.

Responsible for Stars Quality rating for all offices.

Charted audit findings in Excel and relevant systems, ensuring accuracy and completeness.

Collaborated in reviews and quality record assessments to improve performance.

Worked on roles involving Protected Health Information (PHI) regularly in electronic and paper formats.

Scheduled and conducted internal audits to ensure adherence to quality standards.

Stayed current with guidelines and regulations in HEDIS to ensure compliance.

Performed data collection, abstraction, data entry, and performance improvement activities.

Utilized various EMR systems including ECW, Athena, Total Md charts, Aprima, and Amazing Charts.

Centerwell Offices CHMC Medical Management Jan 2020 - Jun 2021

Medical Records Account Manager

Fulfilled requests for medical records for all Centerwell offices and patients under practices.

Managed a team of five employees, providing leadership, guidance, and support.

Oversaw day-to-day operations of the medical records department.

Ensured timely completion of all reports and payroll for the department.

Magellan Complete Care- Orlando FL May 2017 - Jan 2020

Utilization Management Representative

Verified eligibility and benefits for members.

Created Authorization shells for providers or hospitals for procedures and hospital procedures.

Generated retrospective shells for review of past medical services.

Ensured accurate and efficient utilization of healthcare resources.

Centene - Sunshine Health- Orlando FL May 2016 – May 2017

Patient Service Representative

Worked with patient services for insurance verification and customer service.

Provided patient information and assistance with insurance claims.

UnitedHealth Care - Optum May 2013 - May 2017

HEDIS Data Abstractor

Maintained Stars Quality ratings for all offices.

Performed data collection, abstraction, data entry, and performance improvement activities.

Utilized various EMR systems including ECW, Athena, Total Md charts, Aprima, and Amazing Charts.

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