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.
● 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.
● 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.
● Care planning
● Team leadership
● Case management
● PACT SYSTEM
● GSI System
● Psyckes
● E-PACES
● MAPP
● Bilingual
● Medical Terminology