Experienced and dedicated HEDIS professional with a strong track record in enhancing the quality of care and healthcare outcomes. Seeking a challenging role in the HEDIS field to apply skills in data analysis, quality improvement, and project management.
Overview
19
19
years of professional experience
Work History
Sr. Provider Service Representative
Reveleer
Glendale, Ca
09.2019 - 05.2024
Conducted HEDIS audits to assess the quality of care provided to patients
Collaborated with healthcare providers to improve documentation accuracy and completeness
Analyzed audit results and presented findings to management for process improvement
Implemented strategies to increase HEDIS scores and enhance overall performance metrics
Developed training materials and conducted workshops to educate providers on HEDIS requirements
Maintained up-to-date knowledge of healthcare regulations and best practices in quality improvement.
Department Manager
Admissions Adolescent Growth
Pasadena, Ca
09.2017 - 06.2019
Led a team of admissions coordinators to streamline the intake process and ensure timely admission of adolescent patients
Developed and implemented admission strategies to increase patient referrals and meet admissions targets
Conducted regular training sessions for admissions staff to enhance their skills and knowledge of admission procedures
Collaborated with healthcare providers and insurance companies to facilitate the admission process and ensure compliance with regulations
Analyzed admission data and trends to identify opportunities for improvement and implement corrective actions
Maintained a high level of patient satisfaction through effective communication and personalized support during the admissions process.
Documentation Clerk
Shield Healthcare
Valencia, Ca
05.2016 - 06.2017
Managed and organized patient records, ensuring accuracy and confidentiality of information
Reviewed and processed documentation for insurance claims, authorizations, and medical records
Collaborated with healthcare providers and insurance companies to obtain necessary documentation and ensure timely processing
Conducted audits of patient records to verify completeness and compliance with regulatory requirements
Assisted in the development and implementation of documentation policies and procedures to improve efficiency and accuracy
Provided administrative support to healthcare staff, including data entry, filing, and record maintenance.
Senior Loan Processor
JP Morgan Chase
Chatsworth, Ca
06.2010 - 11.2013
Achieved top 10% of National Processor ranking
Worked directly with the customers to ensure high customer satisfaction
Maintained system accuracy
Issued proper disclosures as required by federal regulatory compliance and reviews rate lock and point objectives for accuracy
Set up files and ordered all necessary exhibits for appraisal and credit reports
Prepared and calculated income and assets
Ordered and reviewed title insurance, appraisals, loan payoffs, flood and tax certificates.
Account Manager
JP Morgan Chase
Chatsworth, Ca
01.2005 - 06.2010
Reviewed mortgage applications
Navigated the processing system
Loan analysis
Reviewed compensating factors
Processed pre-approvals for underwriting
Handled sensitive information from customers
Applied needed conditions to ensure borrowers meet program requirements
Performed escrow analysis
Obtained all third-party documentation.
Education
Business Administration certificate -
Job Corps
01.2004
Diploma -
Desert Winds High School
01.2001
Skills
Proficient in HEDIS data collection, abstraction, and analysis
Strong knowledge of NCQA guidelines and HEDIS measures
Excellent project management and organizational skills
Effective communication and collaboration with providers, stakeholders, and team members
Data-driven decision-making and quality improvement strategies
Proficient in EHR systems and data analytics tools
PATIENT INTAKE REPRESENTATIVE at Hackensack Meridian Health System JFK Hospital /NeuropsychologyPATIENT INTAKE REPRESENTATIVE at Hackensack Meridian Health System JFK Hospital /Neuropsychology