Alexandria Sanchez
Kalama
Summary
Experienced and detail-oriented Medical Records Director with experience in overseeing health information management and ensuring the accuracy, confidentiality, and compliance of medical records systems. Seeking employment to utilize my extensive background in EHR with 10 years of experience in healthcare starting as a CNA in skilled nursing to a Medical Records Director with a background in medical assisting, customer service representative, care coordinator and Utilization Review specialist completing clinical reviews for insurance companies.
Overview
11
11
years of professional experience
Work History
Credentialing Specialist
LSJ Credentialing
12.2021 - Current
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Business Management
- Ensure all required documentation is received and submitted in a timely matter.
- Documentation and verification
- Reporting and auditing
- Primary contact for clients and insurance companies
- Follow up on denied claims
- Set up accounts for clients
- Update provider demographics
Medical Records Director
Discovery Nursing and Rehab
11.2022 - 10.2024
- Prepares clinical records for admission, enters orders, and ICD coding
- Daily and monthly audits
- Ensures all departments are in compliance
- Receives and coordinates the response to requests for clinical records from third party entities
- Pull needed reports
- Facilitate PDPM meetings
- Consult with MDS nurse and other nursing staff for dx coding
- Kept accurate log of requests for medical information and records.
- Maintained patient records in compliance with security regulations.
- Reviewed charts and flagged incomplete or inaccurate information.
Utilization Review Specialist
Rainier Springs Behavioral Hospital
05.2022 - 11.2022
- Acts as a liaison between managed care organizations and the facility’s behavioral health clinical treatment team
- Conducts clinical reviews in accordance with certification requirements of insurance plans or other managed care organizations
- Monitors patient length of stay and conducts initial and concurrent reviews when indicated to provide clinical information needed to support medical necessity criteria for appropriate level of care
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Supervised and maintained all utilization review documentation through software.
Discharge Coordinator
Rainier Springs Behavioral Hospital
06.2021 - 05.2022
- Coordinated transfer of out-of-area patients into in-network facilities.
- Identified and referred patients to social work department for additional coverage and services.
- Worked collaboratively with clinical and non-clinical team members to solve complex discharge issues.
- Arranged placement of patients in facilities appropriate for level of care requirements.
- Facilitated timely referrals to alternate levels of care and assisted family or guardian with completion of applications.
- Communicated with referral providers about new referrals and verified receipt of necessary information prior to arrivals.
- Solved problems related to abrupt changes in discharge, coordinated updates and communicated discharge plans.
- Coordinated travel arrangements and contacted family with travel information.
- Worked with utilization review to establish prior authorization for timely discharges.
Medical Assistant/ Receptionist/ Medical Records
Evergreen Medical Center
08.2016 - 05.2022
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Obtained client medical history, medication information, symptoms, and allergies.
- Performed medical records management, including filing, organizing and scanning documents.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Maintained patient records in compliance with security regulations.
- Maintained patient confidence by keeping patient records information confidential.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Assisted in preparation of medical records to release to other medical facilities requesting for patient history and information.
- Reviewed charts and flagged incomplete or inaccurate information.
- Responded to patient inquiries to provide information and details of medical records.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
Care Coodinator
S&S Elite Care
01.2016 - 04.2020
- Maintain Patient Records, Confidentiality and Compliance
- Handling admissions, preparing charts
- Used company software and databases to maintain records of services performed and patient conditions.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Built strong relationships with clients to deliver emotional support and companionship.
- Determined need for special assessment activities for complex cases, effectively handling care plans.
- Maintained patient records in compliance with security regulations.
- Maintained patient confidence by keeping patient records information confidential.
- Assisted in preparation of medical records to release to other medical facilities requesting for patient history and information.
- Printed and photocopied documents to provide patients with copies of medical records.
CNA
Fort Vancouver Post Acute
02.2015 - 08.2016
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Delivered individualized patient care by recording vital signs, documenting observations, administering treatments, and evaluating patient needs.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
Home Health Aide
Chesterfield Services
09.2014 - 02.2015
- Followed nutritional plans to prepare optimal meals.
- Provided mobility assistance such as walking and regular exercising.
- Traveled to clients' homes to complete healthcare services and promote continuity of care.
- Encouraged patients to participate in safe physical activity to help boost mood and improve overall wellness.
Education
Certified Coding Specialist -
The Andrews School
Oklahoma City, OK08-2025
Bachelor of Science - Healthcare Administration
Charter College
Vancouver, WA05.2021
Skills
- Management of Patient Records
- Data Entry and Management
- Ensure Compliance
- File Organization
- Document Review and Auditing
- Patient Access Support
- Filing and Record Retrieval
- Prepare Reports
- Training and Support
- Insurance Reviews
- Run PDPM
- Consult with MDS Nurse on Coding
- PCC Expert
- Scribe
- Credential verification
- Data acquisition
Timeline
Medical Records Director
Discovery Nursing and Rehab
11.2022 - 10.2024
Utilization Review Specialist
Rainier Springs Behavioral Hospital
05.2022 - 11.2022
Credentialing Specialist
LSJ Credentialing
12.2021 - Current
Discharge Coordinator
Rainier Springs Behavioral Hospital
06.2021 - 05.2022
Medical Assistant/ Receptionist/ Medical Records
Evergreen Medical Center
08.2016 - 05.2022
Care Coodinator
S&S Elite Care
01.2016 - 04.2020
CNA
Fort Vancouver Post Acute
02.2015 - 08.2016
Home Health Aide
Chesterfield Services
09.2014 - 02.2015
Certified Coding Specialist -
The Andrews School
Bachelor of Science - Healthcare Administration
Charter College
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