Data Analyst Pharmacy
Resume:
Contact
HIMANI SHARMA
*********@*****.***
Top Skills
ICD-10/CPT Coding
Auditing and Compliance
Insurance and
Documentation
SAS and SPSS Research
Analytics
Revenue management
Research and Education
Nursing and Healthcare
Management
MPA Healthcare Administration, BSN
Brooklyn, New York
Experience
Family Healthcare and Cardiac Center
Quality Analyst
February 2019 - Present (1 year 2 months)
• Analyze and perform coding updates and changes for complex cases and provides billing coding direction.
• Review for third-party reimbursements and perform data quality reviews and prepare complex reports as required.
• Establish and review process for coding compliance.
• Attend coding and reimbursement workshops and implement the information as appropriate;
• Stay informed about transaction code sets, Health Insurance Portability and Accountability Act (HIPAA) requirements.
• Review medical record documentation for billed CPT, Level II HCPCS and ICD-10 diagnosis codes.
• Prepare audit reports and performing follow up based upon the results
• Determine the CMS and third-party payer regulations are being complied with medical record documentation and evaluating appropriateness of billing and coding procedures.
• Review and recommend accurate coding and billing reimbursement.
• Work collaboratively with healthcare personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies.
• Assign and code all ICD-9 and ICD-10 diagnoses, as well as applicable CPT procedures.
• Analyzes ICD-10 (diagnoses) and CPT (billing codes) to determine whether information is properly recorded in the patient encounter before the encounter is closed and sent to billing.
• Performs any other duties, as necessary, to achieve success for the organization.
New Horizon Counseling Center
Data Analyst ( Care Coordination)
January 2018 - February 2019 (1 year 2 months)
Page 2 of 4
Far Rockaway
• Provided administrative, organization and technical support to the coordination team in the tabulation and analysis of data.
• Evaluated care coordination data and identified errors created by operational, claims and eligibility processes.
• Worked closely with vendors and government agencies (medicaid, medicare) to monitor, analyze and communicate aggregate and individual encounter metrics
Lakeville Pharmacy
Senior Billing Specialist
May 2017 - December 2017 (8 months)
Greater New York City Area
• Set up and maintain a system of keeping records and the preparation of yearly budgets.
• Design and organize job descriptions and prepare annual performance evaluation of all employees.
• Perform selection of departmental staff and give orientation and supervision.
• Maintain and oversee drug inventory weekly by comparing excel spreadsheets provided by the Micro-merchant systems and wholesalers.
• Oversee labeling of drugs, supplies, and chemicals properly.
• Process medical insurance claims and accept payments.
• Provide outstanding customer service while building rapport and improving pharmacy patient relations
Richmond Hill Pharmacy, Ltd
Senior Pharmacy Technician
May 2015 - April 2017 (2 years)
Greater New York City Area
• Set up and maintain a system of keeping records and the preparation of yearly budgets.
• Design and organize job descriptions and prepare annual performance evaluation of all employees.
• Perform selection of departmental staff and give orientation and supervision.
• Maintain and oversee drug inventory weekly by comparing excel spreadsheets provided by the Micro-merchant systems and wholesalers.
• Oversee labeling of drugs, supplies, and chemicals properly.
• Process medical insurance claims and accept payments.
• Provide outstanding customer service while building rapport and improving pharmacy patient relations
Page 3 of 4
Fortis Healthcare
Teaching Assistant
December 2011 - January 2014 (2 years 2 months)
Chandigarh Area, India
• Developed interdisciplinary care plan and case management tools and participated in various meetings.
• Maintained cooperative relationship among health care teams by communicating information, responding to requests and building rapport
• Coordinated care requirement with other healthcare providers
• Resolved various conflicts and fostered peer support by education case management process.
• Evaluated the outcome of care by measuring effectiveness of intervention with team.
Government Hospital
Healthcare Specialist
February 2010 - December 2010 (11 months)
Amritsar Area, India
• Documented patient care services by charting in patient and department records.
• Maintained continuity among nursing teams by documenting and communicating actions, irregularities, and continuing needs.
• Maintained patient confidence and protects operations by keeping information confidential.
• Ensured operation of equipment by completing preventive maintenance requirements; following manufacturer's instructions; troubleshooting malfunctions; calling for repairs; maintaining equipment inventories; evaluating new equipment and techniques.
• Maintained professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
(Community Health Center, India)
Student Intern
August 2009 - February 2010 (7 months)
• Provided various family planning services and charted in patient and department records.
• Promoted sanitation and hygiene practices among various community groups.
• Analyzed risk assessment and screening of communicable diseases. Page 4 of 4
• Performed health education activities on different health care topics in different age group people.
• Maintained government health care record and provided healthcare referrals. Education
Long Island University, Brooklyn, NY
Master of Public Administration - MPA, Health/Health Care Administration/ Management · (2015 - 2017)
Khalsa College Of Nursing - India
Bachelor's degree, Nursing Education · (2007 - 2011)
Contact this candidate