Summary
Overview
Work History
Education
Skills
Certification
Summary Professional
Affiliations Professional Memberships
Timeline
Generic

Andrea A. Jones

Westwego,LA

Summary

Dedicated and reliable professional skilled at multitasking with a positive attitude. Committed to exceeding team goals and achieving success. Experienced in providing guidance to improve employee performance. Willingness to take on added responsibilities to meet team goals.

Overview

18
18
years of professional experience
1
1
Certification

Work History

HIM Site Supervisor-Health Information Management

LCMC Healthcare
03.2020 - Current
  • Responsible for overseeing the day-to-day operation of assigned area to ensure proper staffing and distribution of work assignments to maximize productivity and cost effectiveness while delivering high quality work.
  • Provide support to staff when needed, to ensure all operational activities are completed daily.
  • Consistently and effectively implements and monitors workflows, work queues, and all processes for LCMC system HIM daily operations.
  • Effectively trains staff on all operational changes and daily workflows to ensure efficient and high-quality work processes.
  • Demonstrates appropriate judgement regarding daily operating issues.
  • Demonstrates the ability to resolve conflict when issues occur with processes, staff, or external customers.
  • Monitors the productivity and effectiveness of each team member as it relates to a culture of excellence.
  • Monitors employees’ time keeping, through requested time off and approved schedules. Monitors overtime and 'clockwatching' at the time clock.
  • Supervises all activities of the HIM Department as assigned.

Revenue Integrity Liaison-Revenue Integrity

LCMC Health-Westpark Campus
07.2018 - 03.2020
  • Provided guidance, communication and education on correct charge capture, coding and billing processes to multiple clinical departments and facilities.
  • Participated in projects related to revenue cycle initiatives with a degree of autonomy appropriate to experience and project complexity.
  • Collaborated with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit and other Revenue and Finance departments on revenue management initiatives.
  • Analyzed changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications. Executes work plans to adapt systems and processes to accommodate changes.
  • Monitored government and commercial payers for updates and changes to billing requirements. Communicated and educated clinical and administrative staff on actions required to comply with new regulations.
  • Audit charges being captured by clinical departments for accuracy and completeness. Ensure charges are crossing over for billing as intended.

Third Party Analyst-Revenue Integrity

LCMC Health-Westpark Campus
11.2017 - 07.2018
  • Responsible for daily coordination, monitoring and support of third-party audits.
  • Received and processed requests for third party, federal and state government agencies including, RAC, MAC and MIC.
  • Ensured complete timely tracking and submission of records for all requests from third party payor and pre-paid request.
  • Coordinated and communicated audit requests to the audit/appeals team and assist in the timely submission of appeal letters.
  • Daily monitoring of web sites for request for pre-paid/Additional documentation request (ADR).
  • Provided status reports and timely communication of claim appeals to Audit and Appeals Nurses.
  • Trained new incoming employees on processes.

Recovery Audit Contractor (RAC) Analyst

West Jefferson Medical Center
05.2013 - 11.2017
  • Assisted in implementation of RAC Process (guidelines to comply to for processing RAC requests).
  • Created workflows and spreadsheets for communication between various departments pertaining to RAC.
  • Delegated tasks to RAC team members to ensure efficiency and accuracy in obtaining, filing, and releasing of medical records.
  • Tracked and updated RAC request in RAC tracking system and other RAC excel documents.
  • Provided financial data and analysis for internal and external reporting.
  • Assisted with appeals that are Non-clinical or MS-DRG related, as it relates to missing documentation.

Recovery Audit Contractor (RAC) Release of Information

Ochsner Health System
04.2011 - 05.2013
  • Managed Regulatory Audit tracking tool, regulatory requests for information, tracked assignments for completion and trained new employees.
  • Monitored RAC website for updates on claims, statuses, and provide routine communication to RAC team.
  • Coordinated response to audit requests, challenges questionable determinations, and assists in filing appeals.
  • Logged and processed release of medical records to RAC in a timely manner and assure quality of records prior to release.
  • Provides financial data and analysis for internal and external reporting.

Health Information Management Specialist

Ochsner Health System
03.2010 - 04.2011
  • Updated physician’s information in Mainframe and Invision operating systems.
  • Created new referring Physician identification numbers and updated privilege status.
  • Resolved daily error reports.

Health Information Management Coordinator III

Ochsner Health System
08.2007 - 03.2010
  • Updated computer programs to reflect the status of incomplete records and generate daily/weekly reports for pending records.
  • Served as conflict liaison for the professional medical staff. Handled day-to-day administrative office operations, to include human resources duties.
  • Trained and assisted Physicians on Horizon Patient Folder (HPF) database.

Education

Master of Applied and Natural Science - Health Informatics

Louisiana Tech University
Ruston, LA
11.2012

Health Information Technology - Practice Workflow & Information Management Redesign Specialist

Delgado Community College
New Orleans, LA
11.2011

Bachelor of Science - Social Counseling

Our Lady of Holy Cross
New Orleans, LA
12.2006

Skills

  • Workflow processes
  • Training staff
  • Conducts meetings with staff
  • Organizational skills
  • Written and oral communication
  • Resolving issues

Certification

Certified Registered Health Information Administrator (RHIA), 2015

Summary Professional

  • EPIC
  • On-Base
  • VCO-Legacy Medical Records
  • Sharepoint
  • Word
  • Excel

Affiliations Professional Memberships

  • American Health Information Management Association (AHIMA), 2014-08-01
  • Louisiana Health Information Management Association (LHIMA), 2014-08-01
  • President of Greater New Orleans Health Information Management Association (GNOHIMA), 2023-2024
  • Current District Representative of Greater New Orleans-Louisiana Health Information Management Assoc., 2024-2025
  • Current Recruitment Committee-Louisiana Health information Management Assoc. (LHIMA), 2023-2025

Timeline

HIM Site Supervisor-Health Information Management

LCMC Healthcare
03.2020 - Current

Revenue Integrity Liaison-Revenue Integrity

LCMC Health-Westpark Campus
07.2018 - 03.2020

Third Party Analyst-Revenue Integrity

LCMC Health-Westpark Campus
11.2017 - 07.2018

Recovery Audit Contractor (RAC) Analyst

West Jefferson Medical Center
05.2013 - 11.2017

Recovery Audit Contractor (RAC) Release of Information

Ochsner Health System
04.2011 - 05.2013

Health Information Management Specialist

Ochsner Health System
03.2010 - 04.2011

Health Information Management Coordinator III

Ochsner Health System
08.2007 - 03.2010

Health Information Technology - Practice Workflow & Information Management Redesign Specialist

Delgado Community College

Bachelor of Science - Social Counseling

Our Lady of Holy Cross

Master of Applied and Natural Science - Health Informatics

Louisiana Tech University

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