Professional Summary
Overview
Work History
Education
Skills
Certification
Timeline

Kimberly Daniels

Florida Health Care Plans
DAYTONABEACH,FL
1
Certification
18
years of professional experience

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.
Read More

Daytona State College

No Degree from Medical Biller/Coder
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Kimberly Daniels