Brenda Smith *** Chelsea Way Lake Wales Fl.*****

Cell 239-***-**** Hm 863-***-****

Email:adfd7l@r.postjobfree.com

linkedin.com/in/brenda-smith-3774a390

I’m looking for Part-Time Employment

Education

Bachelor of Science in Health Informatics

Western Governors University

Salt Lake City Utah. Graduation Date:

06/2017

Associate of Science in Health Information Management

Polk State College -

Winter Haven, FL

2011

Certificate in Medical Coding

Polk State College -

Winter Haven, FL

2009

License Practical Nurse

Eastern Center for Arts and Technology

Willow Grove, PA

1982

Certifications:

Project +Certification offered by CompTIA

Registered Health Information Technician (RHIT) accreditation through AHIMA (American Health Information Management Association) and CAHIIM (Commission on Accreditation for Health Informatics and Information Management)

License Practical Nurse

Current CPR Certification through the American Red Cross.

Preparing to take RHIA (Registered Health Information Administrators exam) accredited

through AHIMA and CAHIIM.

Work Experience

COVID19 Nurse

All Medical Personal

July 2020-Present

•Part-time position preforming COVID19 swabs on NBA Players.

•Performing nasal and oral swabs.

PRN Rehabilitation Nurse

White Sands Treatment Center

February 2020 – 4/1/2020

•Provide daily nursing assessment for drug/alcohol withdrawal.

•Administer medication according to detox guidelines.

•Monitor and document physical/psychological response to treatments.

•Provide all medical and emergency care as needed.

•Receive and transcribes doctor’s order.

Medical Records Processor

STAT Informatic Solutions LLC

November 2019- February 2020

•Process varies hospital’s medical records before

•scanning for:

•Compliance,

•Completeness

•Legibility

•Format

•Correct Identification

•Quality

Bill Review Nurse

Conduent

May 2019

Workman’s Compensation Claims Review

•Responsible for reviewing and auditing Workman Compensation Claims.

•Responsible for reviewing and determining Reconsiderations claims.

•Auditing and repricing EMG’s claims

•Auditing and reviewing Level of Service (LOS) determinations.

•Verifying rather codes are bundled or unbundled.

•Verifying documentation and charges of procedure performed.

Healthcare Compliance Specialist

Compliance Department

Quality Health Plans of NY

July 2018 – May 2019

•Ensure the compliance of the Medicare Advance Health Plans of NY to CMS Guidelines.

•Collect Data to perform audits for Hybrid Measures (HEDIS) used by vendors to compare against NCQA accreditation standards.

•Audit and Analyze clinical documentation results for quality Improvement purposes used for internal and external reporting.

•Analyze the data entered are accurate and the documentation are compliant to the guidelines.

•Observation for any HIPPA violations.

•Provide information to staff where quality improvement is needed.

Utilization Review Supervisor

Aspire Health Partners, INC

May 2018 – July 2018

A Behavior Health Facility

•Ensure accurate and thorough documentation of medically justifiably treatments.

•Ensure the progress and discharge planning are documented as they are performed by the physician, clinician and nursing team.

•Ensure patient medical history and physical exam is completed in a timely manner.

•Ensure the compliancy of the interdisciplinary team to performed procedures and treatments in a timely matter.

•Performed review with patient’s insurance company to ensure covered days for hospitalization.

Medical Records/Utilization Review Supervisor

MSLA (Medical Service of Los Angeles) for United Health Group

November 2017 to March 2018

•Supervise seventeen (17) team members for the Veterans Administration by monitoring productions, attendance, quality, and their process.

•Auditing my employees for compliance to the VA requirements.

•Provide Quality Improvement Methods.

•Review Records for UM

•Responsible for providing coaching, deliverance of corrections action plans (CAP) (initial, elevated, and finials).

•Running reports on Excel with Pivot tables and filtering.

•Attend Managerial, Corporate and Leadership Meetings.

LPN Charge Nurse

FMA Staffing

July 2017 to September 2017

Charge Nurse at a Medicare/Medicaid facility for clients with addition and psychiatrics diagnosis.

•Admit clients

•Provide medical assessments

•Transcribe Physician orders

•Provide medications and treatments as ordered

•Document all nursing assessments.

•Audits records for quality improvement and documentation guidelines concerning behavior health.

•Provide emergency medical care for clients and team members

•Supervise or team members

•Monitor clients and notify physician of any pertinent information.

Health Informatics/Quality Improvement Department, Florida Hospital

7/16- 9/16

•Sebring Florida (Externship) Function as a Clinical Data Analyst to Audits Inpatients Core Measures for CMS Compliance in the Quality Improvement Department with Cathy Jaco and the Health Informatics Department with Brenda Foster

•Audits Outpatients Core Measures for CMS compliance

•Analysis of workflow issues.

•Develop and submit status reports

•Conduct orientation to new employees on using Cerner Software.

Data Manager Coordinator

Florida Hospital

March 2012 to Dec. 2013

The DMC is responsible for maintaining the database for the Research Department, including (abstracting data, auditors, data entry, running queries, verifying unclear points in the medical records and collaborating with other health care providers to obtain specified data items, collecting data points). I was responsible for updating patient follow-up information and assisting with Research Studies. Maintaining IRB qualifications for the Research staff.

Data Manager Specialist

Florida Hospital

May 2011 to March 2012

The Data Manager Specialist is responsible for auditing inpatient and outpatient medical records and abstracting pertinent data, verifying medical information such as CMS compliances to core measures, perform utilization review for necessity of procedures. Review of databases, including internal as well as reference and comparing databases as needed to collect data. Responsible for verifying unclear points in the medical record and collaborating with other health care providers to obtain specified data items. Responsible for updating periodic patient follow-up information.

•Electric Health Records Audits for CMS Core Measures compliance

• Get with The Guidelines (GWTG) For CMS Meaningful Use

• EHR abstraction

•Provide Utilization Review

Health Information Management

Highlands Regional Medical Center -

Sebring, FL August 2009 to December 2009

(Externship)

• Explain query opportunities to clarify the etiology of systems.

• Interpret medication administration record to look for query opportunities.

• Interpret radiology results to look for query opportunities.

• Analyze emergency department documentation for admitting diagnoses.

Health Information Management

Palm Garden -

Winter Haven, FL April 2009 to August 2009

(Externship)

• Enter medical diagnosis and treatments codes into EHR

• Verify insurance information.

• Verify Doctors orders and nurse’s compliances.

• Close charts of discharged patients.

LPN

Maxim Healthcare Services -

Lakeland, FL April 2008 to February 2009

• Administered flu clinic immunizations, and wellness clinics.

• Complete care of pediatric patients on ventilation machines providing managed care.

Private Duty Nurse

LPN

Interim Healthcare -

Lakeland, FL

March 2006 to February 2007

• Provided managed care for a quadriplegic.

•Administered medication and scheduled all doctor's appointments

• Performed direct care and necessary treatments.

Dialysis Nurse

Gambro Healthcare -

Philadelphia, PA & Lake Wales FL

March 2000 to June 2003

• Assessed clients before starting dialysis treatments.

• Monitored patients during treatment and administered medications via ports

• Received and transcribed doctor's orders, supervised technicians and assessed their

patients.

• Performed post and emergency treatment.

LPN Charge Nurse

Care Pavilion of Walnut Park -

Philadelphia, PA

September 1999 to March 2000

Maintained a thirty-bed skilled LTC unit for Medicare/Medicaid patients.

MDS assessments, attended treatment plans and departmental meetings.

Received written and verbal doctor's orders, administered medication, performed tube feedings and treatments.

Admitted and transferred patients, made and supervised assignments for nursing assistants.

LPN Charge Nurse

Connections of Wilmington, DE

September 1994 to August 1999

•Provided managed care for the elderly with medical and psychiatric diagnosed.

•Maintained a forty-bed group home, transcribed doctor’s orders administered medications and treatments.

Additional Information

QUALIFICATIONS:

• Proficient in Cerner, Microsoft Word, PowerPoint, Excel

• Over 34 years in the Nursing Profession utilizing management skills.

• Ability to interact professionally and efficiently with various populations.

• Experienced with Documentation.

• Ability to keyboard (45 wpm).

• Skilled in Medical Coding.

• Member of AHIMA (American Health Information Management Association)

COMPUTER SKILLS:

Proficient in Cerner, Microsoft Word, Power Point, Excel, Avatar.

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