Summary
Overview
Work History
Education
Skills
Activities
Timeline
AssistantManager
Retunda Culpepper

Retunda Culpepper

COLUMBUS,OH

Summary

Motivated and personable business professional with extensive management experience, versatile skills, and a track record of accomplishments. Experienced nurse aide providing hands-on patient care in hospital and private practice settings. Expertise in reviewing provider medical records for HEDIS data and processing invoices for payment to vendors. Excels at coordinating and monitoring quality improvement and organizational projects from start to finish, ensuring compliance with NCQA requirements. Exceptional communication skills, both verbal and written, enable effective collaboration with professionals at all levels. Highly skilled in documentation, time management, and handling sensitive data. Known for adaptability and ability to work independently or as part of a team, consistently demonstrating professional judgment in Healthcare Effectiveness Data and Information Set (HEDIS) data collection and abstraction. Strong computer skills, including proficiency in Microsoft Office, contribute to driving positive outcomes in conflict resolution and problem-solving situations.

Overview

36
36
years of professional experience

Work History

Quality Improvement Abstractor and Invoice Processor

Buckeye Health Plan - Centene
11.2017 - Current
  • Data collection for medical record review and abstraction
  • Assist during HEDIS off-seasoning with HealthCheck Data Entry and calls
  • Population Health Solution – participation in three subgroups to identify resolve for cause and failure in a system
  • Track and process invoice payments for medical record retrieval

Office Manager and Insurance Referral Specialist

Messick and Thompson MDS, Inc
11.1995 - 11.2017
  • Monitor and evaluate staff work performance
  • Oversee operational budget
  • Order office and medical supplies via company credit card and account
  • Maintain office emergency crash cart
  • Assist RN with patient care and documentation of vital statistics
  • Assist members with health insurance authorization for lab and test scheduling
  • Notify area pharmacy for new drug prescription orders
  • HEDIS data collection, preparation, and submission to insurance companies
  • Develop change in revenue intake, resulting in increase
  • Responsible for updating the provider credentials
  • Act as provider liaison to health plan and pharmaceutical representatives
  • Assisted with CPT, ICD-10 and HCPCS coding

Clerical and Patient Care Coordinator

Wexner Ohio State University Medical Center
01.1989 - 01.1998
  • Assist triage nurse with initial newborn and routine care
  • Assembled medical records upon patient’s arrival to the medical unit
  • Signed off and completed conditions for physician orders
  • Transport patient to lab and diagnostic test, when short staffed
  • Track and update all admissions and discharges

Education

Master's Degree - Health Administration

University of Phoenix
Tempe, AZ
10.2015

Bachelor - Health Administration

University of Phoenix
Tempe, AZ
12.2011

Associate of Arts - Health Administration

Western International University
Phoenix, AZ
05.2007

Skills

  • Team player
  • Diversity, Equity, and Inclusion
  • Confidentiality
  • Medical Records Management
  • HEDIS
  • Project Planning
  • Quality Improvement
  • Records Retrieval
  • Requirements Gathering
  • Organization
  • Accountability
  • Work ethic
  • Payment Handling
  • Quality Improvement Programs
  • Office Administration
  • Personal Initiative
  • Project Implementation
  • Project Management Life Cycle (PMLC)

Activities

  • I strongly support and participate in community outreach.
  • I volunteer for various programs supported by Buckeye Health Plan.
  • I was awarded by the Wexner Ohio State University Medical Center for Intensive Caring and received an Honorary Citation from the Ohio Senate and the Ohio House of Representatives.
  • I am certified as a State Usher for the Church of God of Christ.
  • I am also an honorary member of the National Association of Professional Women.

Timeline

Quality Improvement Abstractor and Invoice Processor

Buckeye Health Plan - Centene
11.2017 - Current

Office Manager and Insurance Referral Specialist

Messick and Thompson MDS, Inc
11.1995 - 11.2017

Clerical and Patient Care Coordinator

Wexner Ohio State University Medical Center
01.1989 - 01.1998

Master's Degree - Health Administration

University of Phoenix

Bachelor - Health Administration

University of Phoenix

Associate of Arts - Health Administration

Western International University
Retunda Culpepper