Health Information Manager-Medical Records Director
Resume:
Dorothy J Foster-RHIT, CCS-P
***** ******* ******, *******, ** 23831
Phone-804-***-**** ********@*******.***
Objective
HIM Professional is seeking a position in Health Information Management or Analysis in order to use current experience in a comparable position within a Healthcare setting
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HIM Director and Privacy Officer Poplar Spring Hospital, Petersburg, VA
Behavior Health Facility- 2020-2021
Directive from Corporate Office to bring facility Health Information Department up to date with other UHS Mental Health facilities.
Revamped medical records filing system and storage process for medical records.
Implement manual processes into current system applications.
Worked with MS4, Nuance, HCS, 3M Coder, Concord Faxing, and Midas software application.
Prepared Medical Records for Corporate Audits and Insurance Audits
Participated in facility chart audits.
Processed Release of information request according to policies and state regulations.
Managed Coder, Chart Assembler, Medical Records Clerks
Work with Corporate HIM Staff to implement new polices for HIM department.
Worked with physicians and Medical Director on timely notes and chart discrepancies.
Assisted Business office with releasing medical records in order to obtain payment.
Monitored reports for coding and worked with Coder to get all billable charts completed.
Process facility HIPAA breaches according to company policy
Completed HIPAA training for new orientees.
Trained staff to new process changes.
Updated old policies with revised policies.
Completed all required training.
Medical Records Request Manager
Payment Error Rate Measurement (PERM) Program
AdvanceMed/CMS Contractor, Richmond, VA
2018-2020
Initiated the startup program for the Richmond PERM Facility
Established five PERM departments: Customer Service Call Center, Scanning department, Quality Assurance department, Quality Analysis department and Mailroom.
Attended weekly and daily Center for Medicaid and Medicare Service meetings.
Meeting with CMS State Representatives for all states pertaining to their audit requirements.
Worked with 17 different states per quarter.
Met established matrix goals for medical records request on quarterly and annual goals.
Created Standard Operating Procedures (SOPs) all departments, Customer Service Call Center, Scanning Department, Quality Assurance Department, Quality Analysis Department and Mailroom
Managed a staff of 20 employees.
Completed staff evaluations and employee annual goals.
Conducted monthly staff meetings.
Worked with Physician and other Healthcare providers pertaining to their audit requirements, medical records and billing information needed.
Participated in weekly management meetings.
Worked with company liaisons to resolve CMS issues and concerns.
Worked with IT and Application and Development for system improvements.
System Applications included: Avaya- Call Center Telephone System
ARMS- Record Management System
SMARTDOC-Record scanning processing system
Ephesoft- Quality Assurance and Quality Analysis Systems
Microsoft 10
Excel, PowerPoint, Outlook and Word.
HIM Operations Manager
Southern Virginia Regional Medical Center, Emporia, VA
2017 – 2018
Maintain hospital policies and procedures.
Worked in an EMR setting as well as Hybrid medical record-setting.
Followed HIPAA regulation pertaining to Release of Information and Protected Health Information
Reviewed Unbilled Report for edits and maintaining appropriated AR Days
Worked with Coder and Department Directors to resolve unbilled issues
Analyzed Coding, Productivity and Hold reports
Compiled and Analyzed data for Weekly and Monthly Corporate reports
Managed all HIM personnel staff, Coder, Analysis, Scanner, ROI Clerk and Health Information Specialist
Used various software applications to manage daily HIM operations procedures, includes:
Evrichart application-Upload medical records for billing issues
Compliance 360 application-Monitor BOM appeals to various insurance companies.
M-Modal Clarity Application-Physician dictation system
Clinview application-Review completed physician progress notes and H&Ps. Also review physician notes for E-Signatures
Emprint application- Hospital’s forms system
3M 360 application- Coding system
Med Host application-hospital Health Information system
Completed Joint Commission Reports
Monitored and Audited HIM performance indicators
Worked closely with physicians pertaining to timely
E-Signatures
Participated in Forms Committee Meetings, Morning Meetings, QA Meeting and Safety Meeting
Monitored and maintained staffing coverage
Processed and authorized staff daily time sheets
Medical Records Director
HCR ManorCare, Richmond, VA
2004 – 2017
Reviewed Discharge records
Performed medical records audit in order to establish compliance.
Review new admits paperwork and provided correct ICD9 and ICD10 and CPT codes for billing.
Implemented system for storing and maintaining current medical records.
Audit electronic medical records reports for documentation deficiencies.
Provided in-services to nursing and clinical staff pertaining to documentation issues.
Proficient in Word 2010, PowerPoint, Publisher and Excel
Prepared records for Legal reviews and CMS reviews
Supervised Medical Records Assistant and Clerks
Advised Director of Nursing on documentation issues.
Prepared Medicare and Insurance claims in the appeals process
Submitted medical records to Medicare and Medicaid for review
Released medical records according to HIPAA regulations.
Process physician’s application for privileges
Participated in facility's annual licensure survey pertaining to medical records issues as requested by surveyors.
Created plan of corrections for any medical records deficiencies after the annual survey.
Implemented systems for compliance after the annual survey.
Participated in facility’s Assisted Living licensure survey.
Participated in QAA Meeting
Outcomes Coordinator
Trained new medical records clerks from other outside company facilities.
A strong knowledge base of state and federal regulation pertaining to medical records compliance
Education
AAS Degree
Northern Virginia Community College, Springfield, VA
06-2006
Health Information Program GPA 4.0
06-2004
Health Record Coding Certification
J Sergeant Reynolds Community College
Health Record Coding Technician Program GPA 3.8
2004-2006
AHIMA RHIT and CCS-P Credentials
2014-2015
Licensed Virginia State Assisted Living Administrator (National Association of Long-Term Care Administrator Board Certification Program)
Qualified applicants will have a demonstrated ability in strategic and tactical planning, application of management practices and principles, and technical systems analysis. Knowledge of IT environments and applications. Knowledge of Medicaid Management Information Systems (MMIS) or other large-scale health care processing systems is required. Requires a comprehensive knowledge of the Health Insurance Portability and Accountability Act (HIPAA), including Electronic Data Interchange (EDI) Transactions and Code Sets. Must have extensive skill in applying project management principles to manage multiple projects within established timelines. Must have a demonstrated skill in communicating both orally and in writing to a diverse audience. Ability to develop and maintain project budgets, resource plans, risk and contingency plans is required. Extensive experience in managing large-scale Information Technology (IT) projects that includes development of project work plans is also required.
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