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Health Information Manager

Location:
Asheboro, NC
Posted:
January 07, 2020

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Resume:

Vanessa Daniels

**** **** ***** ****, *******, NC 27298

336-***-**** ada8lx@r.postjobfree.com

SUMMARY

Healthcare & Health Information professional with over 18 years of healthcare experience with a history of performance excellence in the areas of Medical Administration (billing and coding), Process Improvements, Licensure/Regulatory Compliance, Staff Training, and Human Resources. Impeccable communication skills and an unwavering dedication to the success of all endeavors and assignments. Strong ability to interact with a diverse population of varying cultural and ethnic backgrounds with ease. Routinely relied upon for expertise, advice, leadership, guidance and management skills. Managed high volumes of medical records containing diagnosis, medication administration records, treatment administration records, nursing notes, MD Notes, MD orders, authorization/certification of initial and ongoing treatment that complies with strict regulations and standards.

Registered Health Information Technician (RHIT) (NO.0026351)

Healthcare Information Management

ICD-10 Certified

Claims Processing

Lawson Payroll Management and Processing

Physician and Staff Scheduling

Patient Scheduling

HIPAA/JCAHO Compliance

Accounting and Budget Reconciliation

Confidential Records Management

EPIC EMR

Meditech EMR

HIM Preceptor

Personnel Management

Training Principles

Meticulous Attention to Detail

Microsoft Office Suite

Recovery Audit Contractor (RAC) Audits

WORK EXPERIENCE

UNC REX Healthcare

Chapel Hill, NC

4/2019- Present

Supervisor HIM Operations On- Site

Responsible for Wakebrook, Hillsboro, UNC Medical Center and Eastowne Corporate location HIM Departments

Responsible for 17 direct reports, overseeing scheduling, payroll, productivity, work assignments and audits for quality and compliance

Liberty Healthcare

Chapel Hill, NC 06/2016 – 4/2019

Health Information Manager

Health Information Manager for an 80-bed and 120 bed skilled nursing/long-term care and assisted living combination facility (Medicare and Medicaid Certified).

Participated in the National Nursing Home Quality Initiative and the Payroll Based Journal reporting program; part of a team where the overall ratings were as much as three stars, and Quality Measures were rated as five stars.

Participates in weekly Medicare and Medicaid Meetings as a member of the interdisciplinary team (IDT), reviews patient care plans, assigns ICD-10 codes, renews MD certifications and medication orders.

Completes monthly chart audits, and reports findings to appropriate staff/supervisor and present findings quarterly in Quality Assurance Program Improvement (QAPI) Program.

Trains practitioners (MD/NP/PA) involving physician engagement software, and coordinates the receipt of documentation through HIPPA Compliant programs that interface with community software.

Assist Regional Health Information Administrator (RHIA) with training newly hired Health Information Managers (HIM) and preceptor for clinical and clerical interns in the duties and responsibilities of the position.

Participates as a member of the IDT during complaint and annual health and fire inspections, participates in developing plans of correction that ensures community compliance with state rules and regulations for Skilled Nursing Facilities.

Support and train the IDT through quality documentation and improvement in an effort to reduce insurance denials and improve reimbursement.

Maintain a hybrid system: Electronic Health Record (EHR) and paper documentation system that coincides with the standards for storing, archiving, retrieval, and destruction of medical records.

Manages all Requests for Information (ROI) that meets applicable law.

Participates in a Manager on Duty (MOD) program in order to timely respond to resident, family, and staff concerns appropriately, and provide applicable/amicable solutions.

Genesis Healthcare, Grafton, WV 11/2015 – 07/2016

Health Information Management Coordinator

Health Information Management Coordinator for a 120 bed skilled nursing care facility (Medicare and Medicaid Certified).

Participated in the National Nursing Home Quality Initiative and the Payroll Based Journal reporting program; part of a team where the overall ratings were as much as four stars, and Quality Measures were rated as three stars.

Performs ICD coding in consultation with the Minimum Data Set (MDS) Nurse or the Director of Nursing (DoN).

Creates and manages all medical records for new admissions, readmissions, and current residents as directed by Director of Nursing (DoN).

Maintain a hybrid system: Electronic Health Record (EHR) and paper documentation system that coincides with the standards for storing, archiving, retrieval, and destruction of medical records.

Conducts routine chart audits to monitor compliance with policies regarding documentation, physician visits, order(s) accuracy, and timeliness, etc.

Manages all Requests for Information (ROI) that meets applicable law.

Responds to telephone inquiries concerning medical records and may respond to correspondence, as directed by center management.

St. Joseph’s Hospital, Buckhannon, WV 08/2015 – 11/2015

Coding Specialist

Coding Specialist for a 51-bed medical/surgical-hospital with a volume of 12,799 Emergency Room Visits and 1,260 Admissions annually.

Review claims data to ensure that assigned codes (ICD-10, CPT, and HCPCS) meet required legal and insurance rules.

Ensure required prior approval/authorizations are obtained prior to the start of treatment.

Assign modifiers when/where appropriate in order to obtain accurate reimbursement.

Conduct medical records research to resolve claim denials.

Utilize the hospital chargemaster to identify, enter, and correctly invoice for services provided.

United BioSource Corporation, Morgantown, WV 12/2014 – 08/2015

Sr. Reimbursement Specialist

Risk Evaluation Mitigation System (REMS) Project with Genentech Biotechnology Corp for the FDA.

Verify benefits and process multiple claims for new FDA approved drug- Esbriet

Conduct benefits investigations in order to quickly and accurately make determinations regarding appeals and denials.

Obtain and maintain patient medical and treatment records with confidentiality/privacy.

Maintain an accurate record of prior authorizations, re-certifications, and notice of medical non-coverage.

Participate in various calls with providers, clients, and representatives, regarding the status of claims and services/products to be provided.

Conduct analysis of medical monitoring of side effects and report findings in weekly executive summaries.

Train and educate providers, clients and representatives on program requirements and facilitate referral processes.

Facilitate and train, and provide on-going training to new and current staff on organizational processes and procedures regarding claims and reimbursement.

ADDITIONAL WORK EXPERIENCE

Preston Memorial Hospital, Kingwood, WV 12/2013 – 10/2014

Patient Access Supervisor

Managed 12 Direct Reports

Fairmont General Hospital, Fairmont, WV 2011 – 2013

Documentation Review Analyst/ Coordinator

Member of the Recovery Audit Contractor (RAC) Team

Fairmont Regional Cancer Center, Fairmont, WV 10/2011 – 11/2011

Internship, Health Information Technology

EDUCATION

Lincoln College of New England, Southington, CT

Associates of Applied Science in Health Information Technology 2013

License/Certification

Registered Health Information Technician (RHIT), No. 0026351 Exp. 3/18/2020

Licensed since 2013



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