Sandra Miranda
Katy,TX
Summary
Organized Medical Records Clerk brings top talents in data entry, records filing, and administrative correspondence. Creates new medical records, retrieves existing medical records, and collects demographic information from various sources to gather patient information. Seasoned Medical Records Clerk with 10 years of hands-on experience managing patient health files in healthcare facilities. Well-versed in preparing new patient records, processing admission procedures and discharge records, and obtaining records from off-site storage facilities. Organized and coordinated individuals committed to adhering to HIPAA privacy policies.
Overview
13
13
years of professional experience
Work History
Medical Records Abstractor/OVERREAD
United Healthcare
01.2024 - Current
- Analyzed and extracted pertinent medical information from patient records for data entry into the electronic health record system.
- Reviewed charts to ensure accuracy of abstracted data.
- Conducted quality assurance checks on abstracted data to verify accuracy.
- Provided feedback and recommendations to improve documentation in patient records.
- Analyzed medical records to ensure accuracy and completeness of information.
- Coded diagnoses, procedures, and services according to established standards.
- Assigned ICD-10 codes for inpatient, outpatient, and emergency room encounters.
- Reviewed clinical documentation for accurate coding of diagnosis and procedures.
Medical Records Abstractor/Overread - Healthcare Effectiveness Data and Information Set
Optum
01.2023 - 06.2023
- Abstract /overread requested HEDIS measures and In-Office Assessment Programs
- Maintained accuracy, completeness, and security for medical records and health information
- Reviewed charts and flagged incomplete or inaccurate information
- Maintained excellent attendance record.
Virtual Medical Scribe
Nuance Communications/Cognizance
05.2022 - 01.2023
- Specialty: Orthopedic Care and Podiatry
- Type the exact words heard during a patient-provider interaction or from a dictated note
- Interpretation of medical conversations
- Documenting each doctor-patient encounter, handling charting information, and updating patient records.
Medical Records Abstractor/Overread - Healthcare Effectiveness Data and Information Set
Optum
01.2022 - 05.2022
- Abstract /overread requested HEDIS measures and In-Office Assessment Programs
- Maintained accuracy, completeness, and security for medical records and health information
- Reviewed charts and flagged incomplete or inaccurate information
- Maintained excellent attendance record.
Medical Records Abstractor - Healthcare Effectiveness Data and Information Set
Anthem
01.2021 - 05.2021
- Abstract requested HEDIS measures
- Maintained accuracy, completeness, and security for medical records and health information
- Reviewed charts and flagged incomplete or inaccurate information
- Maintained excellent attendance record.
Patient Service Representative
Cypress Comprehensive Medical Services
10.2018 - 01.2021
- Update and verify patient information at every visit
- Assist patients with filling out patient history forms, consent forms, and payment contract forms
- Receive and process cash and credit card payments for medical services rendered
- Review patient accounts, identify delinquent accounts, and collect overdue payments
- Answer, investigate, and direct patient inquiries or complaints to the appropriate medical staff member
- Contacting health plans and obtaining referrals and authorizations
- Referral Coordination
- Assisting patients in finding in-network providers.
Member Services
Molina HealthCare Inc.
01.2011 - 04.2017
- Respond to Incoming calls from members and providers
- Clearly explain benefits, eligibility, provider status, workflows, guidelines, services, and any other necessary information to members and providers
- Accurately record calls in QNXT and QSHR and follow up as necessary to maintain specific quality standards
- Research problems or correspondence
- Provide the best solutions available with Medicaid or Medicare Healthy Family Policy or contract guidelines
- Worked cooperatively with other departments
- Responsible for implementing and monitoring local QI and HEDIS interventions
- Assist the Interventions Manager in implementing provider or member interventions
- Works on removing barriers to provide better care at the provider or member level
- Assist in data entry
- Worked with HP Reporting to produce reports on interventions' progress and success rates
- Responsible for Uploading, Distributing, Renaming, and Requesting all medical records that come in through ( Fax, Mail, CD, Flash drives, and scanning)
- Onsite retrieval and scanning of medical records
- Communicate effectively and professionally with care healthcare provider offices, clinics, and other clinical facilities
- Abide by all HIPPA and associated patient confidentiality requirements.
Medical Records Abstractor/Overread - Healthcare Effectiveness Data and Information Set
United Healthcare
01.2024
- Abstract /overread requested HEDIS measures and In-Office Assessment Programs
- Maintained accuracy, completeness, and security for medical records and health information
- Reviewed charts and flagged incomplete or inaccurate information
- Maintained excellent attendance record.
Education
International Institute of Design and Technology
West Little York Christian Academy
Skills
- 10 years' experience in providing thorough customer service and administrative support
- Proficient in Spanish
- Microsoft Office Suite
- Quickbooks
- Nitro Pro 11
- MNXT
- QSHR
- ICD Knowledge
- Proficient in the following Electronic Medical Records:
- EPIC EMR System
- Next-Gen
- All Script
- E-Clinical
- Powerchart
- Athena
- 10 years' experience in Healthcare Effectiveness Data and Information Set (HEDIS) abstraction and over read
- Electronic Health Records Management
- Medical terminology proficiency
- Medical terminology understanding
- Medical Terminology
- Data Entry
- Document Scanning
- Written and verbal communication
- HIPAA Regulations
- Filing systems expertise
- Filing procedures
- Medical Transcription
- Record maintenance
- Customer Service
- Paperwork Processing
- Insurance Eligibility
- New patient chart preparation
- Meeting Coordination
- Records Management
- Work well independently
- Medical Billing
- Medical Records Management
- Scheduling appointments
- File Organization
- HIPAA Compliance
Languages
English
Professional
Spanish
Native/ Bilingual
Timeline
Medical Records Abstractor/OVERREAD
United Healthcare
01.2024 - Current
Medical Records Abstractor/Overread - Healthcare Effectiveness Data and Information Set
United Healthcare
01.2024
Medical Records Abstractor/Overread - Healthcare Effectiveness Data and Information Set
Optum
01.2023 - 06.2023
Virtual Medical Scribe
Nuance Communications/Cognizance
05.2022 - 01.2023
Medical Records Abstractor/Overread - Healthcare Effectiveness Data and Information Set
Optum
01.2022 - 05.2022
Medical Records Abstractor - Healthcare Effectiveness Data and Information Set
Anthem
01.2021 - 05.2021
Patient Service Representative
Cypress Comprehensive Medical Services
10.2018 - 01.2021
Member Services
Molina HealthCare Inc.
01.2011 - 04.2017
International Institute of Design and Technology
West Little York Christian Academy
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