ALYSSA CARLSON
North Attleboro,MA
Summary
Dedicated HIM Analyst professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
20
20
years of professional experience
Work History
Nocturnal transplant coordinator
Faulkner Hospital
Jamaica Plain, MA
02.2018 - 07.2020
- Responsible for management of patients in various areas of care, including but not limited to AlloMap and AlloSure testing
- Assessed children's developmental progress, specializing in perceptual/sensory motor skills, fine motor skills and activities of daily living.
- Follow up with transplant staff when requests for patient testing are incomplete
- Highly experienced skills and understanding of hemodialysis, PD, transplantation, CKD education, case management and nutritional training
HEDIS Quality analyst
Blue cross blue shield
Providence, RI
01.2018 - 07.2020
- Acting lead specialist with project-, program-, and / or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments
- Responsible for extracting EMR from various EHR’s: eCW, Athena, Cerner, Epic, Amazing Charts, Allscripts, Nextgen, Meditech, eVIPS, etc
- Review pended chart requests from vendor and work both internally and externally to assist in obtaining charts (strong ICD-9 & ICD-10 knowledgeable)
- Experience reviewing and maintaining all audit tools to comply with NCQA, TJC, DNV, CMS, Federal and State requirements
- Track MRR vendor performance and provides outcomes to HEDIS abstractors’ and manager Manages multiple projects by effectively prioritizing work and communicating workload issue to manager
- Responsible for OIG, FEP, RADV and HEDIS audits to obtaining relevant evidence to provide reasonable basis for conclusions regarding the activity or organization under examination
- Ensure to track, measure, report and evaluate vendor performance
- Coordinate and lead Vendor-specific JOC meetings with stakeholders quarterly to drive continual development improvements and achieve goals
- Troubleshoot all vendor problems and present to management as required
- Projects: CMS STARs, Medicare CAHPS and Care Program, IHA’s VBP4P program and Vendor management (Matrix & Signify for Medicare IHA) assistant pD coord
- Documented action plans and details of visits and reported critical incidents and quality of care issues.
- Partnered with physicians and staff to explore new ways to encourage member clinical participation in wellness and education.
Deficiency/Chart Analyst
Sturdy Memorial Hospital
Attleboro, MA
05.2021 - Current
- Specialist/physician suspension & patient Portal liason | sturdy memorial hospital |, Accurately analyzes work lists and queues within Cerner's Hyperspace to assign deficiencies
- Concurrently analyzes H&Ps within 24 hours of admission, operative reports within 24 hours of procedure, and discharge summaries within 24 hours of discharge utilizing the Cerner work queues
- Interacts with entities' Medical Staff Office, providers, providers' offices staff, and clinical areas with the suspension process
- Prepared statistical analysis plans and provided statistical interpretation for graphs, tables and charts.
- Checked source data to verify completeness and accuracy, addressing incomplete or missing data fields to streamline application of analytic scripts.
- Maintains and updates suspension list
- Collaborates with clinical areas to obtain documentation to fulfill regulatory requirements and meet revenue cycle targets, as requested by management
- Manipulated, transformed and analyzed data by reviewing computer reports, printouts and performance indicators.
Dialysis Patient Care Technician
American Renal Association
Wellesley, MA
01.2007 - 04.2020
- Assisting in examination and evaluation of patient candidates to arrange appropriate peritoneal dialysis treatment and other services
- Conduct weekly reviews of treatment flow sheets to ensure accuracy, pre/post assessments, q 15-minute vital signs and machine readings are documented, and UF goal is appropriate for reaching EDW, etc.
- Explained dialysis procedures to patients and answered questions and concerns prior to starting dialysis.
Education
Master of Arts - Health Informatics
National University
La Jolla, CA 05.2001 -
Bachelor of Arts - Business Administration And Management
University of Phoenix
Tempe, AZ 05.2001 -
Skills
Skills & Abilitiesundefined
Timeline
Deficiency/Chart Analyst
Sturdy Memorial Hospital
05.2021 - Current
Nocturnal transplant coordinator
Faulkner Hospital
02.2018 - 07.2020
HEDIS Quality analyst
Blue cross blue shield
01.2018 - 07.2020
Dialysis Patient Care Technician
American Renal Association
01.2007 - 04.2020
Master of Arts - Health Informatics
National University
05.2001 -
Bachelor of Arts - Business Administration And Management
University of Phoenix
05.2001 -
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