Anita Ray
HEDIS Specialist
Independence,MO
Summary
I'm looking forward to serving as a contingent HEDIS Abstractor, utilizing nine years HEDIS and Supplemental Data Set (SDS) experience to help your plan succeed in the NCQA HEDIS measure review.
Overview
10
10
years of professional experience
Work History
Contract HEDIS Abstractor
Favorite Healthcare Staffing - Kansas City
02.2024 - 05.2024
- Reduced research timeframes by skillfully navigating various EMR's and HMR's to download pertinent medical records for review..
- Abstracted medical records for HEDIS Quality Measures.
- Produced detailed title reports that accurately documented member medical records for specific dates of service for HEDIS Quality Measures.
- Contacted group providers in an effort to obtain medical records per contract requirements.
Performance Quality Analyst
Blue Cross Blue Shield KC
07.2015 - 01.2024
- Prepare HEDIS Training materials in collaboration with other trainers and Team Leads
- Abstract medical records for Supplemental Data Set (SDS) and Primary Source Verification (PSV)
- Access Electronic Medical Records (EMR/EHR) to extract medical records for abstraction for HEDIS and PSV
- Conduct overreading/auditing for various measures during HEDIS review
- Maintain a 98% or higher abstraction accuracy rate
HEDIS Abstractor
Favorite Healthcare Staffing
02.2015 - 07.2015
- Reduced research timeframes by skillfully navigating various EMR's and HMR's to download pertinent medical records for review..
- Abstracted medical records for HEDIS Quality Measures.
- Produced detailed title reports that accurately documented member medical records for specific dates of service for HEDIS Quality Measures.
- Contacted group providers in an effort to obtain medical records per contract requirements
Medical Billing Specialist
Intrathecal Care Solutions
04.2014 - 12.2014
- Contacted insurance companies regarding payment delays on claims,.
- Contacted insurance companies regarding payment delays on claims, on behalf of our patients.
- Contacted insurance companies regarding payment delays on claims, on behalf of our patients.
- Created claims via ICD-9 software for manager approval.
Education
Associate of Science - Health Information Technician
Pinnacle Career Institute
Kansas City, MO06-2014
Associate of Applied Science - Accounting
Penn Valley Community College
Kansas City08-1984
Skills
- HEDIS Abstraction
- Medical record abstraction
- Provider Outreach for member medical records
- 98 % Abstraction Accuracy
- Medical Terminology
- ICD-10
- HEDIS Training Materials co-author
- Team Lead for HEDIS Training and Abstraction
- SDS and PSV abstraction
- Several EMR and HMR for medical record extraction
Timeline
Contract HEDIS Abstractor
Favorite Healthcare Staffing - Kansas City
02.2024 - 05.2024
Performance Quality Analyst
Blue Cross Blue Shield KC
07.2015 - 01.2024
HEDIS Abstractor
Favorite Healthcare Staffing
02.2015 - 07.2015
Medical Billing Specialist
Intrathecal Care Solutions
04.2014 - 12.2014
Associate of Science - Health Information Technician
Pinnacle Career Institute
Associate of Applied Science - Accounting
Penn Valley Community College
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