Francine Caldwell
Flint,Mi
Summary
Skilled in medical record review and fostering patient confidentiality, I enhanced data integrity at Hamilton Community Health Network Administration. Demonstrating strong analytical skills and HIPAA compliance, I improved HEDIS measurement accuracy and trained new hires, showcasing my ability to lead and innovate in health plan operations.
Overview
28
28
years of professional experience
Work History
HEDIS Field Reviewer/Customer Service Representative
Hamilton Community Health Network Administration
07.2008 - 08.2018
- Supported accurate risk adjustment coding by verifying diagnoses documented in medical records, enhancing overall data integrity.
- Worked closely with healthcare providers to resolve documentation discrepancies, ensuring accurate representation of performance data.
- Participated in team meetings and ongoing training sessions for professional development purposes, staying current with industry best practices regarding HEDIS measurement standards.
- Demonstrated strong attention to detail and analytical skills when identifying trends or patterns in HEDIS measurement data, enabling informed decision-making by organizational leaders.
- Collaborated with team members to develop consistent methodologies for HEDIS data collection and analysis.
- Assisted in training new hires on HEDIS measures and review processes, ensuring a smooth onboarding experience for team members.
- Conducted targeted audits on select cases, identifying gaps or errors requiring further investigation or remediation efforts from providers.
File Clerk/Receptionist/Medical Assistant
Dr. Paul Musson
08.2000 - 09.2004
- Assisted with document scanning and imaging projects to support accurate file back-up.
- Identified and corrected inconsistencies in filing systems for increased accuracy.
- Examined, categorized, and sorted incoming documents.
- Created, implemented and monitored filing systems for easy retrieval of records.
- Sorted and classified documents into appropriate filing systems for increased traceability.
- Assisted with data entry and administrative support tasks to help meet team goals.
- Assisted in training new employees on proper filing procedures, ensuring consistency across the department.
- Safeguarded sensitive information with appropriate security measures, including locking cabinets and controlling access permissions in digital databases.
- Prepared new files and assigned tracking identification numbers, resulting in faster retrievals.
- Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
Receptionist/Medical Assistant
Dr. Michael Young
02.1994 - 05.2001
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Kept reception area clean and neat to give visitors positive first impression.
- Resolved customer problems and complaints.
- Answered central telephone system and directed calls accordingly.
- Supported office efficiency by performing clerical tasks such as data entry, photocopying, scanning, and faxing documents.
- Demonstrated strong multitasking abilities while managing numerous tasks simultaneously under tight deadlines.
- Cultivated positive relationships with clients through professional demeanor and excellent interpersonal skills.
- Assisted with onboarding new clients and securing paperwork completion.
Receptionist/Medical Assistant
Dr. Michael Young
02.1994 - 03.1998
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Kept reception area clean and neat to give visitors positive first impression.
- Resolved customer problems and complaints.
- Maintained a well-organized reception area with updated materials, contributing to a welcoming environment for visitors.
- Supported office efficiency by performing clerical tasks such as data entry, photocopying, scanning, and faxing documents.
- Answered central telephone system and directed calls accordingly.
Medical Assistant/Substitute
Dr. Larry Young
02.1991 - 02.1994
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Obtained client medical history, medication information, symptoms, and allergies.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Performed medical records management, including filing, organizing and scanning documents.
- Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
- Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
Education
Bachelor of Science - Nursing
Baker College
Flint, MINo Degree - Medical Assistant
Ross Medical Education Center
Flint, MI05-1982
High School Diploma -
Northern Community High School
Flint, MI06-1978
Skills
- Medical record review
- Patient confidentiality
- Health plan operations
- Data collection techniques
- Medical Documentation
- Electronic Health Records
- HIPAA Compliance
- Medical Terminology
Timeline
HEDIS Field Reviewer/Customer Service Representative
Hamilton Community Health Network Administration
07.2008 - 08.2018
File Clerk/Receptionist/Medical Assistant
Dr. Paul Musson
08.2000 - 09.2004
Receptionist/Medical Assistant
Dr. Michael Young
02.1994 - 05.2001
Receptionist/Medical Assistant
Dr. Michael Young
02.1994 - 03.1998
Medical Assistant/Substitute
Dr. Larry Young
02.1991 - 02.1994
Bachelor of Science - Nursing
Baker College
No Degree - Medical Assistant
Ross Medical Education Center
High School Diploma -
Northern Community High School
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