Carlos Pescoran
Miami,FL
Summary
Detail-oriented and passionate about facilitating excellent patient care. Adept at implementing policies and procedures. Resourceful and motivated to apply time management and organizational skills in various environments. Open willingness to continuously learn and find new opportunities to expand overall 14-year Medical background skills while facilitating company growth.
Overview
14
14
years of professional experience
Work History
Release of Information Specialist
Cleveland Clinic Hospital
04.2022 - Current
- Reduced errors in released records by thoroughly reviewing documentation before submission.
- Promoted patient privacy rights by educating staff members on best practices for handling sensitive information appropriately during the release process.
- Maintained historical reference by abstracting and coding clinical data such as diseases, operations procedures and therapies.
- Streamlined workflows within the department by introducing digital tools that reduced manual tasks involved in processing requests for information release.
- Managed high volumes of record requests efficiently by maintaining excellent organizational skills and attention to detail.
- Actively participated in interdisciplinary team meetings, providing valuable input on release of information matters and contributing to the overall success of the organization.
- Conducted audits on released records periodically for quality assurance purposes, identifying areas for improvement or increased compliance measures as necessary.
- Date stamped requests and highlighted pertinent data to facilitate processing.
- Ensured compliance with HIPAA regulations through diligent tracking and monitoring of protected health information disclosures.
- Demonstrated commitment to continuous improvement by actively seeking feedback from colleagues and supervisors, incorporating suggestions into daily practices for optimal performance.
- Resolved medical record discrepancies by collecting and analyzing information.
- Completed certifications and notarization of documents for court and legal purposes.
- Generated cover letters, pre-payment notices and invoices to mail information to requestors.
- Collaborated with team members to share knowledge, improve processes, and foster a positive work environment.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Tracked and monitored requests for medical records release.
- Identified new methods to optimize medical records management.
Patient Health Navigator
University Of Miami
12.2020 - 04.2022
- Coordinated patient transitions between different levels of care, facilitating seamless handoff processes and reducing risk of inconsistencies in treatment plans.
- Facilitated patient education sessions on various health topics, promoting wellness and disease prevention initiatives.
- Collaborated with interdisciplinary teams to develop comprehensive care plans, optimizing the quality of patient-centered services.
- Enhanced patient experience by providing personalized care plans and resources tailored to individual needs.
- Managed confidential patient records with accuracy and diligence for optimal continuity of care across multiple providers.
- Answered incoming calls, scheduled appointments and filed medical records.
- Followed document protocols to safeguard confidentiality of patient records.
- Trained new staff on filing, phone etiquette and other office duties.
- Organized patient records and database to facilitate information storage and retrieval.
- Facilitated communication between patients and various departments and staff.
- Maintain a working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need.
- Provide patients with all required information regarding appointments and payment policies (e.g. parking, cash policies, anticipated charges, required ancillary services, cancellation policy).
- Initiate pre-registration process and coordinate with the Central Insurance Verification and Patient Access teams to assure pre-registration in the appropriate facility prior to the appointment.
- Provide verification of enrollment and deductible status for persons enrolled in the School's special contract programs.
- Notify patients of their financial responsibility prior to visits for costly ancillary tests or surgical procedures.
- Notify appropriate parties of the appointment time, referral criteria, insurance verification, and prior authorization requirements.
- Verification of private patient insurance information for same day appointments or by request.
- Verification of insurance information, verification of benefits and insurance referral information.
- Contact insurance company through telephone; inquire about patient information and benefits.
- Inquire via insurance companies and HMO’s about referral, authorization information and letters.
- Performs all above-mentioned tasks by paying attention to detail and providing excellent customer service skills with Patients, Physicians and other related members by following the Standard of Excellence and Accountability policy mandated by the University Of Miami Miller School Of Medicine.
- Building partnership with local community physicians and referral sources to the U Health Systems.
- Maintaining communication with patients and the healthcare providers to monitor patient satisfaction with the patient care experience.
Release of Information Specialist
Sharecare Health Data Services
01.2020 - 12.2020
- Completed release of information requests including retrieving patient's medical chart and returning chart, scanning medical record accurately and correctly and transmitting daily, according to requests, established procedures, and established standards of quality and productivity.
- Validated requests and authorizations for release of medical information according to established procedures.
- Performed quality checks on all work to assure accuracy of the release, confidentiality, and proper invoicing.
- Maintained equipment in excellent operating condition (inside and out).
- Provided excellent customer service by being attentive and respectful; insures understanding of customer request and follows-through as promised; and being proactive in identifying client concerns, or problems.
- Received incoming requests including opening mail, telephone inquiries, and retrieving facsimile inquiries, depending on the needs to the client.
- Maintained a neat, clean, and professional personal appearance and observes the dress code established.
- Maintained a clean and orderly work area, insures that records and files are properly stored before leaving area.
- Maintained working knowledge of the existing state laws and fee structure
- Worked within scope of position and direction; willingly accepted assignments to take on additional facilities or help out during backlogs
- Carried out responsibilities in accordance with client/site policies and procedures, including HIPAA, state/federal regulations related to operations, and labor regulations.
- Maintained confidentiality, security and standards of ethics with all information.
- Worked with privileged information in a conscientious manner while releasing medical records in an efficient, effective, and accurate manner.
- Provided training and guidance to new Release of Information Specialists, contributing to their professional growth and development.
- Conducted audits on released records periodically for quality assurance purposes, identifying areas for improvement or increased compliance measures as necessary.
Release of Information Specialist
Baptist Health Hospital
07.2018 - 01.2020
- Opening mail, verification of proper authorization, using the electronic Master Patient Index system to obtain medical record numbers and encounter sites.
- Using chart location system to locate paper charts, using EHR system to locate electronic health information, copying health information, billing for copies of health information when applicable.
- Entering all releases into the electronic Release of Information module, answering telephone calls related to the release of information function and assisting walk-in customers at the Release of Information location.
- Releases are made following HIPAA, CMS regulations, federal and state laws and the Renown Health release of information policies.
Medical Coder
Baptist Health Hospital
07.2016 - 07.2018
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Supported the implementation of electronic health record systems, simplifying the coding process.
Document Scanner
Baptist Health Hospital
04.2010 - 07.2016
- Provided excellent customer service by addressing inquiries in a professional manner and resolving issues promptly.
- Prepared documents for scanning by removing staples, paper clips, and other obstructions that could damage equipment or impede operations.
- Inputted settings onto scanner computer screen by manipulating mouse or typing from keyboard.
- Analyzed documents to produce appropriate shades and best resolution in scanned reproductions.
- Scanned protected health information into the Document Management System as part of the legal medical records for BHSF facilities maintaining integrity of the records.
- Cleaned and maintained equipment processing clear and legible images.
- Ensured accurate and timely processing of records for availability of information for patient care in accordance to The Joint Commission Standards and for coding and reimbursement in accordance to BHSF policies and goals.
Education
Coding And Billing - Coding And Billing
Miami Dade College
Miami, FL05.2016
Associate of Science - Health Information Management
Miami Dade College
Miami, FL05.2015
Skills
- Excellent Verbal and Written
Communication - Interdepartmental Functions Coordination
- Multidisciplinary Team Collaboration
- Financial Reporting Coordination
- Time Management
- Employee Supervision
- Operational Records Maintenance
- Data Analysis
- Critical Thinking
- ICD-10 Coding
- EMR Systems: Epic, Cerner, ECW, Verisma, Sovera
- 3M Encoder
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Release of Information Specialist
Cleveland Clinic Hospital
04.2022 - Current
Patient Health Navigator
University Of Miami
12.2020 - 04.2022
Release of Information Specialist
Sharecare Health Data Services
01.2020 - 12.2020
Release of Information Specialist
Baptist Health Hospital
07.2018 - 01.2020
Medical Coder
Baptist Health Hospital
07.2016 - 07.2018
Document Scanner
Baptist Health Hospital
04.2010 - 07.2016
Coding And Billing - Coding And Billing
Miami Dade College
Associate of Science - Health Information Management
Miami Dade College
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