Karena D. Tilley
Batavia,OH
Summary
Dynamic HEDIS Seasonal Researcher with proven expertise at Elevance Health, excelling in data analysis and medical record evaluation. Adept at ensuring HEDIS compliance and maintaining confidentiality while delivering high-quality results. Recognized for effective communication and critical thinking skills, consistently achieving project deadlines and enhancing quality of care assessments.
Overview
11
11
years of professional experience
Work History
HEDIS SEASONAL RESEARCHER
BCforward Staffing
11.2024 - 04.2025
- Company Overview: HEDIS SEASONAL RESEARCHER for Elevance Health
- Medicare/Medicaid
- Critical Thinking
- Medicare/Medicaid
- Effective ability to assess medical records & clinical information to perform an analysis of a facility's quality of care.
- Effectively collect data remotely and accurately.
- Check medical records for completeness & accuracy according to the Healthcare Effectiveness Data & Information Set performance measures.
HEDIS SEASONAL RESEARCHER
Lancesoft LLC
01.2023 - 05.2024
- Ensured compliance with state laws regarding recordkeeping requirements.
- Entered data into databases accurately and efficiently according to established procedures.
- Collaborated with other departments within the company to ensure completion of projects on time.
- Adhered to strict confidentiality protocols when handling sensitive client information.
- Performed quality control reviews on completed abstracts prior to submission.
- Maintained accurate records of all abstracted documents for future reference.
- Cross-referenced records to ensure completeness and accuracy of abstracts.
LPN - Home Health Nurse
Maxim Healthcare
Cincinnati, USA
11.2019 - 03.2020
- Displayed effective communication skills in initiating therapeutic relationships with patients.
- Maintains excellent customer service standards while providing compassionate care.
- Managed and treated health problems, ranging from common to serious, acute, and complex for pediatric patients by continuously fostering improvement.
LPN Charge Nurse (Karena Spiller)
ONESOURCE / FHCC and MHCC
Cincinnati, USA
01.2014 - 10.2019
- Supported patients emotionally through communication and care by being an advocate.
- Evaluate workflow, establish priorities for time sensitive assignments to ensure quality of work.
- Managed and treated health problems, ranging from common to serious, acute and complex for geriatric patients by continuously fostering improvement.
- Assured quality of caring medical records, Charting on Point Click Care, Admitting and discharging paperwork by establishing good rapport with patients, family, and hospital staff.
- Keep all company systems and data, (including sensitive member data), secure and safe, according to company's data and security policies and HIPAA guidelines.
Education
Certificate of Completion - HEDIS
Remote Learning Services, LLC
09.2022
LPN Diploma - nursing
Brown Mackie College
Cincinnati, Ohio02.2008
Skills
- Data analysis
- Medical record evaluation
- HEDIS compliance
- Charting software
- Confidentiality protocols
- Time management
- Microsoft Office applications
- Medicare and Medicaid knowledge
- Claims and billing knowledge
- Critical thinking abilities
- EPIC proficiency
- Medical records assessment and analysis
- Remote data collection accuracy
License
Licensed Practical Nurse, Ohio, Current, #PN. 130304 M-IV Compact
Timeline
HEDIS SEASONAL RESEARCHER
BCforward Staffing
11.2024 - 04.2025
HEDIS SEASONAL RESEARCHER
Lancesoft LLC
01.2023 - 05.2024
LPN - Home Health Nurse
Maxim Healthcare
11.2019 - 03.2020
LPN Charge Nurse (Karena Spiller)
ONESOURCE / FHCC and MHCC
01.2014 - 10.2019
Certificate of Completion - HEDIS
Remote Learning Services, LLC
LPN Diploma - nursing
Brown Mackie College
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