With a proven track record at Optum Medical, I excel in HIPAA compliance and critical thinking, enhancing patient care through meticulous coordination and quality assurance. My expertise spans across administrative and clinical tasks, significantly improving Hedis Star measure compliance and streamlining patient documentation processes, demonstrating exceptional organizational skills and a commitment to excellence in healthcare management.
Work in busy Family Practice with 8 Providers. Responsible for doing Hedis Star measure work with the Providers and patients to make sure that the exams, labs, and medications are being ordered and followed per Hedis Star Measure. Auditing charts help patient schedule outside exams. Responsible for making sure that all HMO plans are reviewed and approved by doctor before giving out referrals. Obtain authorization from Insurance companies for Specialist offices. Write out referrals, labs orders, and diagnostic orders for patients. Fax out office notes, answer phones, schedule appointments for specialist and diagnostic testing. Check patients out after appointment. Room patients to be seen by the Physicians, perform blood pressure, height, weight, go over medications. Triage patient to see why they are being seen. Perform several different duties, such as do EKG, shots/injections, breathing treatments, strep/ flu test and wound care.
Oversaw front desk employees, assisted with scheduling patients, made schedules for employees, entered charges using CDI-9 codes and CPT codes, ran end of day and deposits, called insurance companies regarding denied claims, sorted mail, filed charts, medical records, answered phones.
Scheduled in office appointments, scheduled surgical procedure and radiological test, obtained insurance verification and authorizations, educated patients on insurance benefits, collected patient’s responsibilities, worked collection accounts to bring delinquent accounts current, addressed medical record request including subpoenas, posted daily charges, keep up with faxes, emails, doctor appointments/meetings.
Assisted Radiologist and Technologist in getting images read and transcribed. Effectively handled multiple task with frequent interruptions, patient scheduling, data entry, outside reads and comparisons, ensured all patient charts were completed and accurate, imported CD images and burning, assisted with medical reports for physicians’ offices as well as Attorney request, ensured all STAT studies were assigned to proper Radiologist.