Detail-oriented Medical Record Abstraction Specialist with proven ability in HCC diagnosis identification and coding accuracy. Adept in HIPAA compliance and medical terminology, ensuring high-quality documentation for optimal patient care.
Work History
Medical Record Abstraction Specialist
4 Years 2 Months
Florida Health Care Plans | 08.2022 - Current
Evaluated and analyzed medical records to identify and abstract hierarchical condition category (HCC) diagnoses and relevant clinical documentation.
Accurately assign and document applicable diagnosis codes based on information contained within patient medical records.
Update patient and medical record information information to ensure documentation is current, accurate, and complete.
Review clinical documentation for gaps or missing information and initiate provider queries when additional or updated documentation is needed.
Collaborate with physicians and healthcare providers to obtain clarification and updated clinical information necessary to support accurate diagnosis abstraction and coding.
Apply knowledge of medical terminology, clinical documentation, coding, concepts, and healthcare record requirements when reviewing patient charts.
Claims Analyst Specialist
1 Year 1 Month
Florida Health Care Plans | 07.2021 - 08.2022
Process and review insurance claims to support accurate and timely claims handling.
Respond to customer phone inquiries regarding insurance coverage and whether services, including physicians' visits are covered under their plans.
Review member and claim information to provide accurate coverage and benefits information to customers.
Communicate clearly with customers while addressing questions and resolving insurance-related concerns.
Communicate clearly with customers while addressing questions and resolving insurance-related concerns.
Culinary Specialist
13 Years 3 Months
Bridgeview Center | 05.2008 - 08.2021
Prepared and delivered meals to patients promptly, following strict food service guidelines and patient care procedures.
Monitor food temperatures to ensure meals meet required temperature and safety standards before delivery.
Support timely and accurate meal service to patients' needs and daily operational requirements.
Served as a mentor , providing guidance and support to fellow team members.
Education
Associate of Science - Registered Health Information Tech.
Daytona State College | Daytona Beach, FL | 12-2020
Student of the year for 2019-2020
President list (Fall 2020)
No Degree - Medical Biller/Coder
Daytona State College | Daytona Beach, FL | 12-2019
Honoree of [Medical Biller/Coder)
Dean's List (Spring 2019), (Summer 2019)
Skills
HCC/Risk Adjustment
Medical Biller/Coder
ICD-10
EHR/EMR Systems
HIPAA Compliance
Medical Terminology
Provider Queries
Certification
A1 Certification
Timeline
Medical Record Abstraction Specialist
Florida Health Care Plans
08.2022 - CurrentRead More
Claims Analyst Specialist
Florida Health Care Plans
07.2021 - 08.2022Read More
Culinary Specialist
Bridgeview Center
05.2008 - 08.2021Read More
Daytona State College
Associate of Science from Registered Health Information Tech.