MARIA CHRISTINA PEREZ
Baltimore,MD
Summary
Proven expert in medical record abstraction and patient care coordination, leveraging vast EMR and HEDIS knowledge from roles at Johns Hopkins Hospital and Elevance Health. Demonstrates exceptional multitasking and communication abilities, ensuring compliance and enhancing data accuracy for quality reporting. Achieved project management success, meeting stringent productivity standards.
Overview
14
14
years of professional experience
Work History
Patient Access Specialist II
Johns Hopkins Hospital
Baltimore, MD
08.2023 - 12.2024
- Coordinate complex appointment scheduling linking consults and ancillary services required for assigned specialty services within the department, maintaining patient demographics and pre-registration information in appropriate department scheduling system(EPIC, IDX,OCIS)
HEDIS Abstractor
Elevance Health
01.2024 - 04.2024
- Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting
- interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
- Complete assigned abstraction and data entry each day.
- Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters
- Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts
- Prioritize and accurately complete tasks within established times
- Identifying trends and documentation of areas for improvement
- Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities"
Hedis Service Associate II
Elevance Health
01.2023 - 05.2023
- Contacted physician offices as needed to obtain demographic information
- Reviewed records needed and process requests in accordance with HIPAA guidelines
- Coordinated Hedis and other Stars data gathering process
- Evaluated the quality and completeness of the clinical documentation
- Reviewed medical records for data collection
- Answered phone calls concerning ROI issues
- Scanned medical records into database
- Responsible for handling/processing payments for requests
Practice Manager/Referral Coordinator/Associate Healthcare Advocate
Medical Associates of Brevard
05.2020 - 12.2022
- Coordinated patient care with multidisciplinary team
- Provided customer service and conflict resolution with patients and family members
- Obtained prior authorization for diagnostic imaging, prescription medications including IV infusions, VA authorizations, durable medical equipment and referral authorizations for specialists appointments
- Reviewed denials and follow up with provider to obtain medically necessary information to submit an appeal or denial
- Maintained confidentiality of patient health information and adhere to HIPAA guidelines
- Served as an advisor to providers when prescribing medications, medical equipments and supplies to ensure appropriate documentation and order requirements are met
- Performed day-to-day administrative functions and general office duties
- Performed medical chart reviews to look for gaps per HEDIS Measures
- Provided administrative assistance and coordination for projects initiated by Quality Improvement Department, including medical records abstraction related to Star-Rating Hedis and Medicare HCC efforts
- Conducted quality audit and maintain all data and process controls to ensure compliance
- Performed other work related duties as assigned
- Supervised work and performance of clinical medical assistants and other support staff as instructed
Lead Medical Assistant/Referral Coordinator
Medical Associates of Brevard/Spacecoast Hospitalists
06.2011 - 10.2019
- Verified patient information, recorded medical history in the EMR system, confirmed purpose of visits
- Assisted providers with examination and clinical procedures
- Maintained security of medical records
- Oversaw and managed clinical flow and all daily functions
- Assisted in maintenance of medical charts and/or electronic medical records
- Responsible for coordinating the annual HEDIS and medical record submission process
- Evaluated patient care needs, prioritized treatment and maintained patient flow
- Obtained prior authorization for diagnostic imaging, prescription medications including IV infusions, VA authorizations, durable medical equipment and referral authorizations for specialists appointments
- Performed other work related duties as assigned
Education
Bachelor's Degree - Nursing
Philippine College of Health Sciences
01.2008
Bachelor's Degree - Business Administration- Accounting Major
PSBA
01.1999
Medical Coding Course -
Tri County Allied Health
Corona, CaliforniaSkills
- Strong multi-tasker
- Great communication skills
- Knowledge in medical coding (ICD-10)
- MS Office expert
- Experience in internal claims systems research
- Knowledge of managed care and Medicare programs
- Vast EMR, HEDIS review, and abstraction knowledge, and experience
- Project management experience (MCO, Aledade)
- Ability to meet productivity requirements
- Excellent data analysis and research
Professionalreferences
- Jagdeep Chhindra, MD, 321-693-5077, chhind@yahoo.com
- Jose Rodriguez, APRN, 321-759-2646
- Kena Wilson, 321-482-9920
Timeline
HEDIS Abstractor
Elevance Health
01.2024 - 04.2024
Patient Access Specialist II
Johns Hopkins Hospital
08.2023 - 12.2024
Hedis Service Associate II
Elevance Health
01.2023 - 05.2023
Practice Manager/Referral Coordinator/Associate Healthcare Advocate
Medical Associates of Brevard
05.2020 - 12.2022
Lead Medical Assistant/Referral Coordinator
Medical Associates of Brevard/Spacecoast Hospitalists
06.2011 - 10.2019
Bachelor's Degree - Nursing
Philippine College of Health Sciences
Bachelor's Degree - Business Administration- Accounting Major
PSBA
Medical Coding Course -
Tri County Allied Health
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