Medical Assistant, Prior Authorization specialist, Data entry
Resume:
REBECCA RODRIQUEZ, NCMA
**************@******.***
St. Peters, MO 63376
A career driven, experienced Medical Assistant who is looking to broaden her horizons through virtual communication My previous experience includes working in a fast paced Family medicine clinic, triaging patients through virtual care and obtaining HEDIS data abstraction for Medicare and Commercial insurance. I am a balanced, highly capable and Technically minded individual who works well on own initiative as well as in small teams or groups. .
WORK EXPERIENCE
HEDIS Abstractor
Remote
November 2021-April 2022
Reviewing medical records and documents to abstract clinical data for HEDIS reporting.
Integrating collected electronic and hard copy data into reports.
Documenting findings in applicable HEDIS databases and on prescribed cloud-based platforms.
Meeting daily abstraction goals and maintaining a high abstraction accuracy percentage.
Preparing and presenting HEDIS compliance reports to health facility managers.
Training and advising healthcare professionals and administrative staff on HEDIS compliance.
Maintaining HIPAA standards and immediately reporting any critical findings to designation authorities
Obtaining between HEDIS guidelines and measurements within the allotted time frame.
Virtual Triage Navigator-Mercy Virtual
Chesterfield, MO
May 2021-November 2021
Triage patients virtually to assist in determining what level of care they will need.
Allocation of appropriate resources to meet the patients medical needs.
Assist in making appointments and sending correct documentation to the patients primary care physician.
Administer care through Telehealth services
oUsing excellent communication
oCritical thinking and problem-solving
oTime management
Medical Assistant/Prescription Refill Coordinator
Unity Point Health
August 2016 – October 2020
•.Verifying patient information by reviewing current allergies, medical history, medications and obtaining Vital signs. Confirming purpose of visits.
•Assisting physician’s during examinations and or in-patient procedures.
•Knowledge of vaccine schedules; verifying correct vaccine for the correct patient, time, dose, route and administration.
•Authorizing drug refills per protocol.
• Knowledge of Controlled Medications and Prescription Monitoring Program protocols
•Telephoning refills into pharmacies
•Obtaining Prior Authorization from the Insurance company with proper documentation
EDUCATION
Certification- NCMA Medical Assisting
Hamilton Technical College
Graduated; August 2017
High school diploma
West High School
Graduated; May 2009
SKILLS
•EMR Systems; EPIC/eClinical works
•Microsoft Office
•Medical Office Experience
•Clerical Experience
•Insurance Verification
•ICD-10
•Excellent Interpersonal and active listening skills
•Attention to detail and highly organized
•Medical Charting experience
•Knowledge of preparing integrated reports from collected data
CERTIFICATIONS AND LICENSES
NCCT License
Obtained in 2017;
GPA: 3.8 while attending Hamilton Technical College
Deans List obtained for every semester
Basic Life Support by The American Red Cross: CPR Certification/2021
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