Summary
Overview
Work History
Education
Skills
Timeline
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Michelle Cook

Willis,Texas

Summary

Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth. Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.

Overview

16
16
years of professional experience

Work History

Abstractor-Clinical Quality Analyst

UHG-Optum
03.2022 - 08.2024
  • Accurately and efficiently conducted medical record review/abstraction services as per HEDIS/NCQA and input into the electronic data capture tool
  • Maintained a 98-99% accuracy and performed above average with 100 chart abstractions per day.
  • Identified gaps in care and reported findings to review department
  • Performed quality over-read on work completed by other data abstractors
  • Supported data mining initiatives by identifying key data elements within multiple documentation systems.
  • Demonstrated strong organizational and time management skills while managing multiple projects.
  • Proficient in multiple computer programs related to medical records, Microsoft Office, Outlook, Excel and website navigation
  • Contributed to a positive work environment by fostering strong professional relationships with colleagues and supervisors.
  • Developed and maintained courteous and effective working relationships.
  • Managed time efficiently in order to complete all tasks within deadlines.
  • Worked flexible hours across night, weekend, and holiday shifts.
  • Demonstrated respect, friendliness and willingness to help wherever needed.
  • Fostered culture of quality, encouraging proactive identification and resolution of potential quality issues.
  • Streamlined defect tracking process, ensuring timely resolution of issues and maintaining high customer satisfaction.
  • Maintained up-to-date knowledge of quality assurance methodologies, applying best practices to daily tasks.
  • Conducted thorough root cause analyses on recurring defects, resulting in the implementation of effective corrective actions.
  • Optimized resource utilization by effectively prioritizing tasks based on project timelines and risk assessment outcomes.
  • Strengthened communication skills through regular interactions with others.
  • Adaptable and proficient in learning new concepts quickly and efficiently.


Eligibility and Enrollment Coordinator-Admin. Assistant III

McKesson-Value Based Care program
04.2019 - 11.2021
  • Review and abstract Oncology data from medical records including pathology reports, surgical notes, and physician notes to determine if a patient has met all the criteria to be enrolled into the Texas Oncology Value Based Care Program through Humana Medicare
  • Un enroll patients from the Value Based Care Program if patient is found to no longer meet certain criteria
  • Verify all medical insurance benefits for each patient at the start of enrollment and every 30 days after until treatment has been completed
  • Conduct monthly revenue cycle management to ensure proper billing and coding criteria are met
  • Performed quarterly auditing of enrolled patients and sent any corrections to be made to either the insurance company or physician’s office to be rectified
  • Demonstrated proficiency in navigating and extracting data from multiple versions of electronic medical records, practice management systems, and internal IT systems
  • Leveraged in-depth knowledge of oncology terminology and chemotherapy treatments (IV, Oral, Hormonal) to analyze and interpret complex data
  • Identified inaccuracies of patient enrollment, electronic medical record documentation and clinical data
  • Actively reached out to healthcare providers to retrieve missing clinical data, contributing to data completeness
  • Met or exceeded enrollment and retention goals consistently.
  • Streamlined enrollment processes by implementing efficient data management and communication strategies.
  • Demonstrated strong organizational and time management skills while managing multiple projects.
  • Developed and maintained courteous and effective working relationships.
  • Learned and adapted quickly to new technology and software applications.

Medical Records Clerk-Night Shift

HCA-Conroe Regional Medical Center
01.2019 - 01.2020
  • Collected approximately 60 charts daily after patients had been discharged from the hospital
  • Sort, classify and scan all medical records to the centralized medical records department for auditing and billing purposes
  • Review medical records for completeness and accuracy including proper coding and correct insurance information
  • Fulfilled responsibilities in accordance with client/patient policies and procedures including HIPAA state and federal regulations related to rules and regulations
  • Uploaded physician progress notes, history, and physicals into electronic medical records.
  • Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
  • Maintained patient privacy and security by monitoring access to electronic health records and reporting any unauthorized activity.
  • Assisted in preparation of medical records to release to other medical facilities requesting for patient history and information.
  • Developed and maintained organized filing system for medical records to adhere to HIPAA regulations.
  • Supported medical staff by providing organized and accurate medical records.
  • Maintained patient records systems by archiving, scanning and indexing important documents and files.
  • Scanned medical records in digital format for easy retrieval and accessibility.
  • Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
  • Responded to patient inquiries to provide information and details of medical records.
  • Supported clinical decision-making by promptly delivering requested medical records to healthcare providers.
  • Reviewed charts and flagged incomplete or inaccurate information.
  • Reviewed medical records for completeness and filed records in alphabetic and numeric order.
  • Followed exact procedures for handling transfers and other releases of medical records.
  • Researched and resolved medical record discrepancies.
  • Maintained accuracy, completeness, and security for medical records and health information.

Medical Records Coordinator

College Park Heart and Vascular
09.2017 - 12.2017
  • Responsible for security and integrity for all medical records in the office according to HIPAA regulations
  • Maintained accurate and complete patient health records, ensuring compliance with regulatory standards (HIPAA, CIHQ)
  • Process requests for medical records in a timely manner, adhering to ROI procedures
  • Kept accurate log of requests for medical information and records.
  • Identified new methods to optimize medical records management.
  • Maintained accuracy, completeness, and security for medical records and health information.
  • Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
  • Supported quality assurance initiatives by regularly reviewing documentation practices and offering recommendations for improvement where needed.
  • Assisted with the transition from paper-based to electronic health records systems, ensuring seamless integration.
  • Improved patient care by accurately maintaining and updating medical records in a timely manner.
  • Contributed to a positive work environment as an active team member within the Medical Records Department.
  • Processed medical records requests from outside providers according to facility, state, and federal law.
  • Managed sensitive patient information securely while responding promptly to authorized requests for access or copies of records when necessary.
  • Liaised between different departments as required to resolve any discrepancies found within patients' charts.
  • Monitored compliance with state regulations governing medical record keeping practices regularly identifying areas requiring attention.
  • Reviewed 40-50 medical records daily for completeness and filed records in alphabetic and numeric order.
  • Utilized electronic medical record systems to store, retrieve and process patient data.
  • Followed up with medical staff regarding missing information in patient records.
  • Researched and resolved medical record discrepancies.
  • Reduced errors in medical records by implementing standardized processes for data entry and verification.

Medical Assistant

Pain Resources, Inc.
03.2008 - 09.2017
  • Verify Insurance benefits for office visits and procedures
  • Responsible for all ROI requests from other physicians, hospitals, insurance companies and attorneys based on HIPAA regulations
  • Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
  • Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Prepared lab specimens for diagnostic evaluation.
  • Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
  • Enhanced clinic efficiency by assisting physicians with routine procedures and diagnostic tests.
  • Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
  • Directed patients to exam rooms, fielded questions, and prepared for physician examinations. Approximately 60 patients on a daily basis
  • Performed medical records management, including filing, organizing and scanning documents.
  • Improved patient experiences by efficiently managing appointments and maintaining organized medical records.
  • Optimized appointment scheduling processes to minimize conflicts and maximize physician availability for patients.
  • Facilitated seamless patient care with thorough and accurate documentation of medical histories, vital signs, and medications.
  • Contributed to positive health outcomes by educating patients on preventative measures, treatment plans, and follow-up care instructions.
  • Answered approximately 80 telephone calls per day to offer office information, answer questions, and direct calls to staff.
  • Collaborated with medical and administrative personnel to maintain patient-focused, engaging, and compassionate environment.
  • Taught patients about medications, procedures, and care plan instructions.
  • Helped improve patient outcomes by educating and advising on relevant treatments and care.
  • Reduced wait times by swiftly processing insurance claims, verifying coverage, and obtaining pre-authorizations when necessary.
  • Streamlined office operations by managing inventory levels, ordering supplies, and organizing storage areas.
  • Assisted in the development of clinic policies and procedures to ensure compliance with industry standards and regulations.
  • Assisted with billing and coding processes, ensuring accurate insurance claims and patient invoicing.
  • Self-motivated, with a strong sense of personal responsibility.
  • Worked effectively in fast-paced environments.
  • Skilled at working independently and collaboratively in a team environment.
  • Proven ability to learn quickly and adapt to new situations.
  • Passionate about learning and committed to continual improvement.

Education

Technical Diploma - Medical Assistant

Texas School of Business/Southland Institute
Houston, TX
12-2001

Skills

  • Data Analysis/Abstraction/Interpretation
  • Communication
  • Teamwork
  • Critical Thinking
  • Problem solving
  • Customer service
  • Database Navigation
  • Research proficiency
  • Teamwork and Collaboration
  • Problem-Solving
  • Multitasking
  • Reliability
  • Excellent Communication
  • Organizational Skills
  • Detail Oriented

Timeline

Abstractor-Clinical Quality Analyst

UHG-Optum
03.2022 - 08.2024

Eligibility and Enrollment Coordinator-Admin. Assistant III

McKesson-Value Based Care program
04.2019 - 11.2021

Medical Records Clerk-Night Shift

HCA-Conroe Regional Medical Center
01.2019 - 01.2020

Medical Records Coordinator

College Park Heart and Vascular
09.2017 - 12.2017

Medical Assistant

Pain Resources, Inc.
03.2008 - 09.2017

Technical Diploma - Medical Assistant

Texas School of Business/Southland Institute

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Michelle Cook