Antoinette Hatchett

Responsibilities

• Works with members and providers to close care gaps, ensure barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction with members and providers at large IPA and/or group practices
• Serves to collaborate with providers in the field, to improve HEDIS measures and provides education for HEDIS measures and coding
• Supports the implementation of quality improvement interventions and audits in relation to plan providers
• Assists in resolving deficiencies impacting plan compliance to meeting State and Federal standards for
  HEDIS
• Conducts telephonic outreach, while embedded in the providers' offices, to members who are identified as needing preventive services in support of quality initiatives and regulatory/contractual requirements
• Provides education to members regarding the care gaps they have when in the providers office for medical appointments
• Schedules doctor appointments on behalf of the practitioner and assists member with wraparound services such as arranging transportation, connecting them with community-based resources and other affinity programs as available
• Maintains confidentiality of business and protected health information
• Acts as a liaison and member advocate between the member/family, physician and facilities/agencies

• I conduct outreach to provider offices and to members to positively affect HEDIS outcomes
• Collaborate and monitor my assigned nurse(s) during HEDIS season with the nurse(s) medical reviews from medical records
• I perform medical record abstraction and data entry

• Customer service representative in the HEDIS department
• Provided administrative and telephonic support
• Called Providers for the copies of their medical records
• Filed and assisted the nurses with research on missing information

• Review, audit and collect unpaid balances
• Work with the Cash Posting and Coding teams as needed to resolve accounts
• The systems that I use are Centricity and ZirMed
• Assist patients in understanding and resolving their accounts

• Provided information, education, coordination, along with empathy for the patient and providers involved in experiencing or treating chronic diseases
• Provided customer service to patients, providers, pharmaceutical company representatives and healthcare service companies for specialty prescription drugs and tests with reimbursement and billing challenges

• Collected, documented in the system, and transferred all necessary demographic data to support the clinical review process and care management