CARLOTA PITTS
Andrews,USA
Summary
Results-driven Health Information Management professional with proven experience supporting correctional and clinical healthcare environments. Recognized for maintaining high-integrity medical records, strengthening compliance, and improving documentation workflows in fast-paced, high-volume settings. Combines a traditional commitment to accuracy and confidentiality with a forward-looking approach to audits, continuity of care, and cross-functional collaboration—well suited for Medical Records, HIM/HIMS, Compliance, and Administrative Healthcare roles.
Overview
13
13
years of professional experience
Work History
Medical Records Clerk
Bluebonnet Detention Center
09.2021 - Current
- Serve as primary steward of detainee medical records, ensuring accuracy, completeness, and regulatory compliance across all health encounters.
- Enter, reconcile, and validate documentation for provider visits, labs, x-rays, immunizations, referrals, and outside consultations within required timeframes.
- Conduct daily and periodic chart audits to identify documentation gaps, trends, and risk areas; communicate findings to healthcare leadership and staff.
- Coordinate continuity of care for transfers and releases by preparing, reviewing, and transmitting complete medical records.
- Process and safeguard Release of Information (ROI) requests in strict accordance with HIPAA and facility policy.
- Maintain detailed records of healthcare services and assist with documentation supporting facility reimbursement.
- Support compliance inspections, internal reviews, and accreditation activities through organized record preparation and rapid response to requests.
- Collaborate with providers, nursing staff, intake, and administration to resolve discrepancies and improve documentation workflows.
- Uphold absolute confidentiality, security, and safety standards while managing sensitive medical information in a correctional environment.
- Apply established policies and traditional recordkeeping standards while adapting to evolving documentation systems and workflows.
Medical Biller / Accounts Receivable
Choice Medical Supply
05.2013 - 08.2021
- Led end-to-end submission of insurance claims for commercial and government payers, ensuring accuracy, timeliness, and compliance with payer-specific requirements.
- Investigated, analyzed, and resolved denied, rejected, or underpaid claims through detailed review of medical documentation, coding, and contractual guidelines.
- Proactively identified denial trends and implemented corrective actions to improve first-pass claim acceptance and reimbursement outcomes.
- Verified insurance eligibility, benefits, prior authorizations, and patient financial responsibility to prevent avoidable denials.
- Prepared, submitted, and tracked appeals with strong supporting documentation, resulting in recovery of delayed or lost revenue.
- Reviewed and validated CPT, ICD-10, modifiers, and diagnosis narratives for alignment with clinical documentation.
- Collaborated closely with providers, billing staff, and insurance representatives to resolve discrepancies and clarify coding or coverage issues.
- Maintained meticulous documentation and audit-ready records while upholding strict HIPAA privacy and security standards.
Education
High School Diploma -
Anson High School
Anson, TXSome College Coursework - Medical Transcription
Texas State Technical College
Abilene, TXSkills
- Medical Records & Health Information Management (EHR & Hybrid Charts)
- HIPAA
- MTC
- ICE & IHSC Compliance
- Daily Chart Audits & Quality Assurance
- Release of Information (ROI)
- Continuity of Care & Transfer Coordination
- Documentation Integrity & Risk Reduction
- Provider, Nursing & Intake Collaboration
- ICD-10 / CPT Familiarity
- Records Reimbursement Support
- High-Volume Data Entry & Accuracy
- Confidential Records Handling
Languages
Spanish
Native or Bilingual
Timeline
Medical Records Clerk
Bluebonnet Detention Center
09.2021 - Current
Medical Biller / Accounts Receivable
Choice Medical Supply
05.2013 - 08.2021
Some College Coursework - Medical Transcription
Texas State Technical College
High School Diploma -
Anson High School