Summary
Overview
Work History
Education
Skills
Timeline
Generic

Caroline Medina

Bronx ,NY

Summary

Disciplined individual skilled in collecting and verifying patient demographic and insurance information and preparing and maintaining medical records. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients.

Overview

7
7
years of professional experience

Work History

ROI Specialist

Bronx Care Health Systems
01.2023 - Current
  • Gather patient information by allowing patients to fill out HIPAA forms to release medical records.
  • Maintain master patient index by completing an assigned portion of the daily audit trail.
  • Initiate the medical record by creating and processing the patient care record folder.
  • Maintains record availability by processing charts into the digital patient database.
  • Retrieves medical records by following chart-out procedures.
  • Keep healthcare providers informed by communicating the availability of requested records.
  • Maintain quality results by following hospital guidelines and standards.
  • Serve and protect the hospital or facility’s community by adhering to federal, state, and local guidelines.

Hedis Specialist

WellCare
10.2021 - 01.2023
  • Followed all company policies and procedures to deliver quality work.
  • Listened and responded to customer requests and forwarded necessary information to superiors.
  • Interpreted clients' needs and introduced services to fit specific requirements.
  • Assisted with staff training to enforce quality, safety and sanitation guidelines.

● Assisted with various aspects of the HEDIS process through the continuous review of records, collection of medical records, and abstraction of medical records and other data.

● Reviewed and analyzed data on medical charts to ensure HEDIS measure compliance.

● Performed other duties as assigned and modified at the manager’s discretion.

● Resolved, clarified codes, and diagnosed conflicting, missing, or unclear information by consulting with doctors or others.

● Reviewed and analyzed data on medical charts to ensure HEDIS measure compliance.


Care Coordinator

NEW York PSYCHOTHERAPY AND COUNSELING CENTER
04.2016 - 04.2020
  • Used company software and databases to maintain records of services performed and patient conditions.
  • Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
  • Built strong relationships with clients to deliver emotional support and companionship.
  • Supported patient care excellence via planning and interpretation of programs.

● Oriented and educated patients and their families by creating appointments to meet with them.

● Developed interdisciplinary care plan and other case management tools by participating in meetings; coordinated information and care requirements with other care providers; resolved issues that could affect smooth care progression.

● Contributed to team effort by accomplishing related results as needed.

● Made outreach efforts for potential Health Home clients, sent by the Department of Health Medicaid program, as well as deactivating patients when outreach attempts fail.

● Searched potential clients via MAPP (Medicaid Analytic Performance Portal) E-PACES and PSYCKES.

● Additional to make sure clients are attending appointments as indicated, completed, and transmitted 2010E supportive individual housing applications for patients.

● Managed 60+ caseload of Home Health Care Clients, assisting clients with Housing (2010E) interviews.

Education

GED -

CUNY PREP
01.2012

Skills

  • EPIC EMR
  • Verbal and Written Communication
  • Transcribing Medication
  • Payment Collection

● Care planning

● Team leadership

  • Clerical Support
  • Data Entry
  • Medical Terminology Understanding
  • Staff Training
  • Case Management
  • Records Management
  • ● Organizational skills

● Case management

● PACT SYSTEM

● GSI System

● Psyckes

● E-PACES

● MAPP

● Bilingual

● Medical Terminology

  • Call Transfers
  • Administrative Duties
  • Scanning and Imaging Software
  • Insurance Eligibility
  • Release of Information Paperwork
  • Customer Service
  • HIPAA Compliance
  • Filing Procedures

Timeline

ROI Specialist

Bronx Care Health Systems
01.2023 - Current

Hedis Specialist

WellCare
10.2021 - 01.2023

Care Coordinator

NEW York PSYCHOTHERAPY AND COUNSELING CENTER
04.2016 - 04.2020

GED -

CUNY PREP
Caroline Medina