M

MIRIAM MARTINEZ

504-***-****

adv9yi@r.postjobfree.com

SUMMARY

ELIGIBILITY ADMINISTRATOR AND COMPLIANCE AND RISK ASSESSMENT ANALYST SUMMARY OF QUALIFICATIONS Risk Adjustment Professional with 7 years' combined experience in account resolution and loss analysis. Solid decision-making skills, substantially acts and escalates issues for resolution/delegation. Excellent mathematical, analytical, organizational, and multi-tasking skills; utilize initiative and fast learning attributes while being able to work productively and effectively.

Experienced in financial management, loss analysis, revenue protection, health information management, medical records auditing, Medical Terminology, Surgical Oncology, Behavioral Health, Medical Secretary, and Administrative Office coordination, open enrollment in Employee Insurance, 401K, Financial Aid Assistance, Career Management, Career Services, Academic Advisor on University level.

Current preparation for Registered Health Information Administrator (RHIA) certification, through AHIMA upon completion of academic program August 2023. Technically proficient, successful in working remotely with reliable home office environment.

Respected Human Resources Manager bringing 5 years of expertise in Mentoring, Onboarding. Multi-tasks effectively on complex projects in Health, Education and Government Consulting environment while adhering to deadlines. Promotes communication and coordination among departments.

EXPERIENCE

Admin/HR Assistant, Human Resources Manager

Chalmette, LA

Nunez Resources/ Dec 2022 to Current

Provided administrative support for, Onboarding for new employees, Affirmative Action Plans for our clients, Background clearance, Data Entry.

Admin/Project Management

New Orleans, LA

Consolidated Management Resources/ Mar 2021 to Dec 2022

Provided administrative support for Senior Management, prepared, and monitored budget reports, and handled complex matters in a confidential and seamless manner.

Consultant on Government Contracts-HR, Security Background, Payroll and Proposals

Physician Risk Adjustment

Educator Nov 2020 to Mar 2021

Ensured compliance and identified objectives to control business process; improved the effectiveness of risk management and adhered to policy and procedures.

Video Conferencing regarding status on records; shared effective feedback and educated providers and clients through PowerPoint presentations and reports.

Processed medical claims and followed up on insurance denials.

Healthcare Patient Access Services

New Orleans, LA

Kelly Services, Oct 2012 to Jan 2021

Reviewed records for completeness, accuracy, and compliance with regulations.

Resolved administrative problems by coordinating reports, analyzing data, and identifying solutions.

Scheduled and assigned administrative projects, expediting work results.

Knowledge of medical terminology, diagnosis and procedural coding in areas including Emergency, Surgical, Radiology and Day Surgery

New technologies/process adopted.

Created and revised systems and procedures by analyzing operating practices, recordkeeping systems, forms control, office layout, and budgetary and personnel requirements, implementing changes.

Worked with facilities, IT, and communications teams to set up and flawlessly execute company all-hands meetings every 2 weeks.

Third Party Billing, managed payments and claims for a medical facility.

Procedural Terminology Coding

Health Insurance and Reimbursement for Medicare and private insurance companies.

Executive Secretary

New Orleans, LA

Tulane University/Lofton Staffing/ Oct 2009 to Aug 2012

Provided administrative support for Senior Management, prepared, and monitored budget reports, and handled complex matters in a confidential and seamless manner.

Screened calls, operated office equipment, compiled reports in Excel, processed invoices, financial statements, and created letters.

Maintained records, technical library, and correspondence files.

Oversaw Gifts & Records Management to ensure prompt and accurate acknowledgement and processing for all contributions to the University.

Performed various clerical or administrative functions, communication with professors.

Organized Finance Case Competitions for top Graduate Schools in the Southeast, where each team was given a Harvard Business School case study analysis for a fictitious Fortune 500 Company.

Career Services for Graduate and Undergraduate students for internship for various Alumni.

EDUCATION AND TRAINING

Certification -Certified Risk Adjustment Coder

Anticipation -Nov 2023

Master of Public Admin

Keller Graduate School of Management Oct 2022

Chicago, IL

Graduate Certificate: Health Services Management

DeVry University Jan 2022

Chicago, Il

Bachelor of Science: Health Information Management

Feb 2021

Dean's List, 2020,2021

Associate of Applied Science: Health Information Technology

Sep 2019

Certificate, Medical Billing and Coding

Sep 2018

ACTIVITIES AND HONORS

American Health Information Management Association (AHIMA) Louisiana Health information Management Association (LHIMA) National Alliance of Medical Auditing Specialists (NAMAS)

CERTIFICATIONS

Project Management Risk Assessment Auditing HIPAA Compliance Detail Oriented Analytical Professional Written and Verbal Communication Adherence to Policies and Procedures Leadership Team Values Microsoft Excel, Word, PowerPoint, and Azure Clinical Research Associate 1 Health Research

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