Ashley Betancourt-Maes
San Antonio,TX
Summary
Thorough Quality Assurance Specialist with 5-year background in Healthcare. Excellent resource management and allocation skills. Aiming to leverage experience and a proven knowledge of data collection and analysis, regulatory compliance, case management and auditing to successfully fill the Healthcare Business Analyst role.
Overview
5
5
years of professional experience
Work History
Medical Quality Assurance Specialist
QTC Management
San Antonio, Texas
07.2019 - Current
- Perform quality assurance audits for general medical and specialty examination reports
- Responsible for timeliness and quality of medical report
- Collaborate with physicians and medical staff to provide case specific feedback to improve quality of clinical reports by clarifying medical documentation and correcting billing codes
- Review clinical documentation and medical reports to ensure compliance with VA regulations and directive
- Review inpatient and outpatient medical records
- Meet personal productivity and quality goals
- Identify quality/compliance problems and recommend solutions
- Analyze data to identify opportunities for improvement
Compliance Specialist
Holy Savior Hospice
San Antonio, TX
02.2017 - 04.2019
- Maintained current knowledge base of existing and emerging Medicare and Medicaid regulations, and guidance documents
- Conducted chart audits of medical records for compliance in regulatory requirements using strong knowledge base of Medicare hospice federal regulations
- Targeted growth strategies and action plans for company revenue
- Developed and maintained positive working relationships with current and potential referral and payer sources
- Explained hospice services and benefits to patients, family members, and significant others to ensure accurate understanding of hospice services
- Audited consent forms to ensure compliance standards were met
- Community liaison and educational outreach
Education
Bachelor of Science - Healthcare Management
Baptist Health System School of Health Professions
San Antonio, TX05.2021
Skills
- Case Management
- Analytical and Critical Thinking
- MS Office
- Interpersonal Communication
- HIPAA Compliance
- Medical Records Management
- Audit Processes
- Quality Management
Timeline
Medical Quality Assurance Specialist
QTC Management
07.2019 - Current
Compliance Specialist
Holy Savior Hospice
02.2017 - 04.2019
Bachelor of Science - Healthcare Management
Baptist Health System School of Health Professions