Summary
Overview
Work History
Education
Skills
Accomplishments
References
Timeline
Generic

KANITA TAVARES

Glen Burnie,MD

Summary

Highly skilled Health Information Specialist with comprehensive knowledge in health information management and medical terminology. Background includes maintaining accurate patient data, compliance with relevant legal requirements, and implementation of electronic health records systems. Strengths encompass strong analytical skills, adeptness at multitasking, proficiency in HIPAA regulations, and superior communication abilities. Significant impact made by improving data integrity and confidentiality protocols in previous roles.

Overview

20
20
years of professional experience

Work History

Lead Health Information Specialist

Datavant (Johns Hopkins Howard County)
Columbia, MD
04.2024 - Current
  • Receive and process requests for patient health information in accordance with Company and Facility policies and procedures.
  • Maintain confidentiality and security with all privileged information.
  • Maintain working knowledge of Company and facility software.
  • Adhere to the Company's and Customer facilities Code of Conduct and policies.
  • Inform manager of work, site difficulties, and/or fluctuating volumes.
  • Assist with additional work duties or responsibilities, as evident or required.
  • Consistent application of medical privacy regulations to guard against unauthorized disclosure.
  • Responsible for managing patient health records.
  • Responsible for safeguarding patient records and ensuring compliance with HIPAA standards.
  • Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record.
  • Ensures medical records are assembled in a standard order and are accurate and complete.
  • Creates digital images of paperwork to be stored in the electronic medical record.
  • Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately.
  • Answering inbound/outbound calls.
  • May assist with patient walk-ins.
  • May assist with administrative duties, such as handling faxes, opening mail, and data entry.
  • May schedules pick-ups.
  • Assist with training associates in the HIS positions.
  • Generates reports for manager or facility, as directed.
  • Must exceed level 1 productivity expectations, as outlined at specific site.
  • Participates in project teams and committees to advance operational strategies and initiatives as needed.
  • Mentor his staff for further professional development.
  • Inform senior leadership of issues, opportunities, or challenges.
  • Assist throughout the region with training, mentoring, and/or coverage as needed.
  • Participate and assist with onboarding activities for new employees.
  • Assist with Quality Assurance tasks, as directed by management.
  • Acts in a lead role with staff regarding general questions, and assists with new hire training and developmental training.
  • Leads training sessions for timely staff development.
  • Other duties, as assigned.

Lead Claims Processor

Versant Health
Linthicum Heights, MD
05.2023 - 04.2024
  • Sort incoming vision claims for Davis Vision, MetLife, Superior Vision, Cigna, Supervisor, and out-of-state vision.
  • Batch OCRs, KFI's reimbursement claims, CMS-1500 claims form into the HSP scanning assistant.
  • Process incoming member's premium payments.
  • Scan into an appointed folder and track on an Excel spreadsheet shared with claims, billing, eligibility, and Davis Vision teams.
  • Reviewed and processed insurance claims in accordance with company policies and procedures.
  • Mail all checks to the lockbox once a week.
  • Print and generate EOBs, and mail them out to members.
  • Point of contact for billing, claims, eligibility, and Davis Vision checks.
  • Ensured accuracy of claim information, managed data entry, and maintained records.
  • Maintained an organized filing system for medical claims to adhere to HIPAA regulations.
  • Sorted the following claims: 1500 forms (HCFA's), UB, Correspondence, Workman's comp, Medicaid, Certified appeals, regular appeals, and Dental.
  • Assisted in training new staff in processing and filing procedures of the claims.

ADMINISTRATIVE COORDINATOR

UNIVERSITY OF MARYLAND MEDICAL CENTER
DOWNTOWN BALTIMORE, MD
02.2023 - 05.2023
  • Assisted Director of Revenue Cycle, Anesthesiology department with special projects
  • Maintained databases for multiple insurances by updating the data log for claims, billing, and coding
  • Managed and maintained an electronic filing system to keep essential documents and information easily accessible and organized
  • Tracked deficiency of signed progress notes, discharge notes, and post-op notes by CRNA and attending physician using EPIC
  • Reviewed and verified CPT codes on HCFA forms and claims in EMR systems assure codes were correct and insurance claim form
  • Assisted with audits, denials, and appeals.

REAL ESTATE SERVICE COORDINATOR

SHARED SERVICE SOLUTIONS S3
LINTHICUM HEIGHTS, MD
09.2022 - 12.2022
  • Performs debit, ATM, and credit card functions, including disputes, chargebacks, and charge-offs
  • Performs card maintenance, case management, limit increases/decreases, and balance transfers
  • Must maintain and secure confidential member information
  • Completes research and adjustments
  • Responsible for document management related to scanning and archiving member documentation
  • Responsible for testing the Core system updates and releases on an ongoing basis
  • Works in collaboration and partnership with other team members.

ADMINISTRATIVE ASSISTANT

JOHNS HOPKINS UNIVERSITY
BALTIMORE, MD
08.2016 - 05.2022
  • Enhanced curriculum quality by collaborating with faculty and reviewing course materials
  • Coordinated professional development workshops to enhance faculty skills and knowledge in their respective fields
  • Processed and implemented travel reimbursement and honorariums
  • Managed social media for six programs within International Studies and programs
  • Ensure proper implementation of Event Planning and space Management policies and procedures
  • Monitor, evaluate, and implement business practices and procedures to support the day-to-day operational needs of the department
  • Develop new administrative policies as needed to ensure smooth operation in the office
  • Prepare and present executive-level reporting to leadership
  • Production of multiple reports and summaries that are requested.

STAFF ASSISTANT

JOHNS HOPKINS HEALTH SYSTEM
BALTIMORE, MD
01.2013 - 08.2016
  • Schedule meetings, conference calls, and appointments, reserve meeting rooms and conference lines order catering, and set the meeting area for the Director of Media for Johns Hopkins Marketing and Communications and her team
  • Attend meetings and maintain records via a compilation of the minutes of the meeting
  • Respond to media inquiries in a friendly, courteous, and professional manner using the proper department greeting.

PRE-AUTHORIZATION COORDINATOR II

UNIVERSITY OF MARYLAND MEDICAL CENTER
DOWNTOWN BALTIMORE, MD
02.2011 - 01.2013
  • Scheduling of patient appointments for ENT, procedures, and diagnostic tests
  • Provide printed schedules in advance to physicians, nurses, radiology, etc
  • Daily
  • Monitor overbooking and/or conflicting scheduling situations and inform the clinic manager as appropriate
  • Assist staff to maintain that patients' insurance and referrals are checked at least one day before the appointment
  • Review the schedule for co-pay obligations and outstanding balances and flag patient accounts
  • Alert staff and patients to prior balances and co-payments
  • Verified insurance coverage and obtained pre-authorizations
  • Followed up with patients to reschedule missed appointments
  • Monitored patient wait times, providing updates to achieve optimal patient satisfaction
  • Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries
  • Resolved scheduling conflicts to maintain high-quality patient services
  • Expertly managed planning, scheduling, and coordination of outpatient procedures
  • Collated pre-operative lab and imaging results to facilitate surgery planning.

MEDICAL RECORDS SPECIALIST

SHEPPARD PRATT
TOWSON, MD
09.2004 - 06.2008
  • Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations
  • Processed medical record requests from outside providers according to facility, state, and federal law (ROI)
  • Respond to patient inquiries to provide information and details of medical records
  • Reviewed charts and flagged incomplete or inaccurate information
  • Uploaded physician progress notes, history, and physicals into EHR
  • Maintained patient records system by archiving, scanning, and indexing important documents and files.

Education

Dental Assisting Certificate -

Fortis College
MD
10.2009

Medical Billing and Coding -

DeVry University
IL

Skills

  • Medical Office Administration
  • EMR/ EHR programs (EPIC, McKesson Sunrise, HealthSource)
  • SAP
  • Payment Collection
  • Medical Billing
  • 3M Coding & Reimbursement
  • ICD -10- PCS
  • Patient Confidentiality
  • Health Information Management
  • Records Management
  • HIPAA Compliance
  • Medical Terminology Understanding
  • Citrix
  • Training and mentoring
  • Clinical Documentation
  • Health Information Systems
  • Microsoft Office
  • RightFax
  • Centrix

Accomplishments

  • Delta Sigma Theta, chapter Johns Hopkins University

References

References available upon request.

Timeline

Lead Health Information Specialist

Datavant (Johns Hopkins Howard County)
04.2024 - Current

Lead Claims Processor

Versant Health
05.2023 - 04.2024

ADMINISTRATIVE COORDINATOR

UNIVERSITY OF MARYLAND MEDICAL CENTER
02.2023 - 05.2023

REAL ESTATE SERVICE COORDINATOR

SHARED SERVICE SOLUTIONS S3
09.2022 - 12.2022

ADMINISTRATIVE ASSISTANT

JOHNS HOPKINS UNIVERSITY
08.2016 - 05.2022

STAFF ASSISTANT

JOHNS HOPKINS HEALTH SYSTEM
01.2013 - 08.2016

PRE-AUTHORIZATION COORDINATOR II

UNIVERSITY OF MARYLAND MEDICAL CENTER
02.2011 - 01.2013

MEDICAL RECORDS SPECIALIST

SHEPPARD PRATT
09.2004 - 06.2008

Dental Assisting Certificate -

Fortis College

Medical Billing and Coding -

DeVry University

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KANITA TAVARES