Medical Records Call Center
Resume:
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Cynthia Neal
Columbia, TN ****1
***********.**@*****.***
Objective
Seeking a position as a Medical Records Technician II & Health Care Patient Representative using well-hon skills in standard coding systems compiling patient’s information as well as compliance with all state federal regulations such as U.S Drug Administration (FDA), (OSHA), (CLIA), (cGMP) and (PHI). Looking for long-term opportunity w/room for growth @ established, fortune 500 organization. Experience in Prime Suite, Excel, Epic, NextGen, Athena, Onbase, & Zenith.
• Education
o Virginia College Healthcare Reimbursement 2011
o Calhoun Community College Phlebotomy 2004-2006
o Columbia State Community College Prerequisites of Nursing 2004 o Business Technology Center Office Administration 1995 Experience
• Aetna/CVS Enrollment Coordinator/Scottsdale, AZ/Sept 2023-Present *Contract o Processing updating electronic medical record for New/Client Eligibility enrollment with Medicare Part (A), (B), and (D) through Silver Script. o Verifying Client (PHI) demographics, insurance with state ranking, LIS, EGWP, etc qualification to ensure accurate documentation.
o Facilitate appropriate healthcare outcomes for client by providing tools, information, and data review.
o Review application and Enrollment paper app and make necessary changes required by federal, state, and local regulations.
o Make (OBC) Out Bound Calls in timely timeframe with additional information to the client.
• Aetna/CVS Health Concierge Specialist I/Highpoint, NC/Sept 2022-Nov2022*Contract o Enrollment insurance for eligibility for insurance Medicare & Medicaid Part A&B o Engage client which coverage would benefit best for them &Verification of PHI through via telephone.
o Prior Authorization of medical records/approval or denial of benefits.
• Team Health/Chart Capture Operations/Knoxville, TN/May2022- August 2022 o Daily reconciliation of patient PHI charts within a set time frames/productivity standards. o Contact clinicians to obtain additional clinical information on incomplete/missing outstanding charts.
o Identify and report Onbase chart flow issues.
o Collect, analyze, and report out on departmental data, maintain adherence to confidentiality standards established in accordance with legal, ethical and hospital standards.(ex: HIPAA compliance)
• Monogram Health/Care Coordinator/Brentwood, TN/April 2022-May2022 o Responsible for the administrative tasks associated with delivering transformative kidney care.
o Inbound/Outbound PCR enroll prospective patients. o Responsible for scheduling telehealth appointments/Knowledge to operate device complete virtue visit.
o Reports all data information directly to the Enrollment and Operations Manager/Assists the District Managers of their care team as needed
• Aetna/CVS NB Policy Processor/Franklin, TN/ October 2021- January 2022* Contract o Comply Multiple administrative & customer service layers determine plan eligibility. o Policy processor position is review, investigation,adjustment IF necessary remittance or denial of the claim.
o Knowledge of Medicare benefits, enrollments, and LIS assistance. o Self- directed, able to problem solve, execution focus.
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• Call 4 Heath/Inbound Patient Care Representative/Spring Hill, TN/December 2018- August 2021
o Answer 100+ Inbound calls professionally, courteously, and compassionately. o Provide accurate, appointments for services as requested by scheduling, canceling, rescheduling, and confirmed appointments with clients. o Visualized/Proofread and updated (PHI)while practicing HIPPA Laws. o Communicated with clients(Reminders)for next day appointments-Daily o Enter/report all calls and contacts in timely, accurate, complete and efficient manner.
o Strategized appointments for(Ten) physicians account’s communicate effectively with upper management with any situation with clients and co-employee’s. o 1st Implemented (Telemedicine)”Video Chat’s” appointment in the state of TN for out of state account.(Call4Health) AIT Scheduling *Letter/Acknowledgement
• Saargummi Automotive / Production Tech / Pulaski, TN / January 2017-September 2018 o Served as work leader, assuring the product met quality standard for the customer.
o Maintain records/logged dates/Data Entry into the Microsoft word system.
• Meadowbrook Nursing Home / House Keeper / Pulaski, TN / March 2013-March 2014 o Ensured maintain the facility & patient room was cleaned.
• Home Health Care / Care Giver / Spring Hill, TN / Oct 2011-August 2012 o Helped patient’s with everyday basic living for as personal hygiene/cleaning.
o Promoted healthy eating habits, exercise according to Doctor’s orders.
• Universal Screen / Phlebotomist & Drug Screener / Columbia, TN / Oct 2011-September 2012
o Prep customer for DNA testing, background checks, & drug testing. o Maintained confidentially of customers information/ Documented on data base.
• Crockett Hospital / Phlebotomist & PRN / Lawrenceburg, TN / January 2011-Feburary 2011 o Handled patient admission, prep for drawing of blood from patient. o Retrieved patient’s blood, & documented analyze information using appropriate computer software system.
• Board of Education / Substitute Teacher & PRN / Pulaski, TN / November 2010-April 2011 o Interact with student’s with curriculum subjects of that day @ task.
• American Red Cross / Medical Records Tech II / Nashville, TN / April 2006-Feburary 2010 o Reviewed client medical records for accurate(PHI) o Properly file, & track blood products management & product,& document control.
o Donor Management & Component Distribution Information Systems Software.
o Protect the security of medical records, & ensured confidentiality. o Quickly, & accurately enter detailed successfully registered 2500+ donor’s a day (3) different regions(KY,TN,IN).
o Highly adept donor’s diagnosis-related information to individuals, agencies in compliance with appropriate regulations.
o Properly sends (PHI) medical records to the correct mailing addresses or Fax number as stated on the medical record copying requested. Process(PHI) onto CD.
o Correctly identify patient by searching correct(PHI) number in Company EMR system/Placed (MDH) if needed.
o Ability to communicated clearly & professionally, & excellent attention to detail.
References:
Marvin Cathey 1506 B Richmond Rd
Columbia, TN. 38401
Cell: 615-***-****
E-Mail: *************@*****.***
Brindy Fuson 224 Longmeadow Circle
Pulaski, TN 38478
Cell: 931-***-****
E-mail:************@*****.***
Michael McDade 945 Cleveland Street
Pulaski, TN. 38478
E-Mail:*********@*******.***
Felicia Simmons 2240 Rosehill Rd.
Pulaski, TN. 38478
Cell: 931-***-****
E-Mail: ****************@*****.***
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